26D2191544 CLIA NUMBER - HINES STREET PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 26D2191544
  • Facility Name: HINES STREET PHARMACY, LLC
  • Facility Address: 1173 E HINES STREET
    REPUBLIC, MO
    ZIP 65738
  • Facility Phone: 417 735-0055
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVE MCCLANAHAN
  • NPI Number: 1790439842
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2191544
LAB Type Pharmacy
Facility Name HINES STREET PHARMACY, LLC
Street 1173 E HINES STREET
City REPUBLIC
State MO
ZIP 65738
Phone 417 735-0055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Pharmacy
Lab Director STEVE MCCLANAHAN

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