26D2048223 CLIA NUMBER - PEVELY RX INC DBA MEDICINE SHOPPE 1985

Laboratory Demographics

  • CLIA Code: 26D2048223
  • Facility Name: PEVELY RX INC DBA MEDICINE SHOPPE 1985
  • Facility Address: JASON WANG PHARM D 8640 COMMERCIAL BLVD
    PEVELY, MO
    ZIP 63070
  • Facility Phone: 636 479-6100
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON WANG
  • NPI Number: 1790034064
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D2048223
LAB Type Pharmacy
Facility Name PEVELY RX INC DBA MEDICINE SHOPPE 1985
Street JASON WANG PHARM D 8640 COMMERCIAL BLVD
City PEVELY
State MO
ZIP 63070
Phone 636 479-6100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Pharmacy
Lab Director JASON WANG

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025