26D2194357 CLIA NUMBER - BUTLER DRUG STORE, INC

Laboratory Demographics

  • CLIA Code: 26D2194357
  • Facility Name: BUTLER DRUG STORE, INC
  • Facility Address: 222 E MAIN STREET
    PORTAGEVILLE, MO
    ZIP 63873
  • Facility Phone: 573 379-5460
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN E. BIDEWELL
  • NPI Number: 1194724880
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2194357
LAB Type Pharmacy
Facility Name BUTLER DRUG STORE, INC
Street 222 E MAIN STREET
City PORTAGEVILLE
State MO
ZIP 63873
Phone 573 379-5460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Pharmacy
Lab Director LAUREN E. BIDEWELL

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