26D2152451 CLIA NUMBER - OLD TOWN PHARMACY #2 LLC

Laboratory Demographics

  • CLIA Code: 26D2152451
  • Facility Name: OLD TOWN PHARMACY #2 LLC
  • Facility Address: 119 E MAIN STREET
    PIERCE CITY, MO
    ZIP 65723
  • Facility Phone: 417 476-2828
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REBECCA J. BECKER
  • NPI Number: 1164976999
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D2152451
LAB Type Pharmacy
Facility Name OLD TOWN PHARMACY #2 LLC
Street 119 E MAIN STREET
City PIERCE CITY
State MO
ZIP 65723
Phone 417 476-2828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Pharmacy
Lab Director REBECCA J. BECKER

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