26D2151650 CLIA NUMBER - THE MEDICINE SHOPPE

Laboratory Demographics

  • CLIA Code: 26D2151650
  • Facility Name: THE MEDICINE SHOPPE
  • Facility Address: 149 POND FORT TRAIL
    LAKE SAINT LOUIS, MO
    ZIP 63367
  • Facility Phone: 636 321-1001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER D. CARROLL
  • NPI Number: 1154878783
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2151650
LAB Type Pharmacy
Facility Name THE MEDICINE SHOPPE
Street 149 POND FORT TRAIL
City LAKE SAINT LOUIS
State MO
ZIP 63367
Phone 636 321-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2024
Certificate Expiration Date 7/23/2026
Facility Type Pharmacy
Lab Director JENNIFER D. CARROLL

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