26D2189023 CLIA NUMBER - MEDICENTER PHARMACY

Laboratory Demographics

  • CLIA Code: 26D2189023
  • Facility Name: MEDICENTER PHARMACY
  • Facility Address: 200 W WASHINGTON STREET
    JACKSON, MO
    ZIP 63755
  • Facility Phone: 573 243-1303
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTINA HART
  • NPI Number: 1811075336
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2189023
LAB Type Pharmacy
Facility Name MEDICENTER PHARMACY
Street 200 W WASHINGTON STREET
City JACKSON
State MO
ZIP 63755
Phone 573 243-1303
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 CHRISTINA HART

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This page was last updated on: 6/4/2025