26D2189297 CLIA NUMBER - GUARDIAN PHARMACY OF MISSOURI

Laboratory Demographics

CLIA Number: 26D2189297

Facility Name: GUARDIAN PHARMACY OF MISSOURI

Facility Address:
2107 E ROCKHURST STE C
SPRINGFIELD, MO
ZIP 65802
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Facility Phone Number: 417 450-4139

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1326490376

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	26D2189297
LAB Type	Pharmacy
Facility Name	GUARDIAN PHARMACY OF MISSOURI
Street	2107 E ROCKHURST STE C
City	SPRINGFIELD
State	MO
ZIP	65802
Phone	417 450-4139
CertificateType	4
CertificateEffectiveDate	7/29/2022
CertificateExpirationDate	7/28/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024