26D2205845 CLIA NUMBER - MAIN STREET PHARMACY

Laboratory Demographics

  • CLIA Code: 26D2205845
  • Facility Name: MAIN STREET PHARMACY
  • Facility Address: 117 E MAIN
    EAST PRAIRIE, MO
    ZIP 63845
  • Facility Phone: 573 649-9229
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRYAN L. HUBBARD
  • NPI Number: 1295366797
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2205845
LAB Type Pharmacy
Facility Name MAIN STREET PHARMACY
Street 117 E MAIN
City EAST PRAIRIE
State MO
ZIP 63845
Phone 573 649-9229
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director BRYAN L. HUBBARD

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