26D2225294 CLIA NUMBER - MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #05697

Laboratory Demographics

  • CLIA Code: 26D2225294
  • Facility Name: MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #05697
  • Facility Address: 3902 MAIN ST
    KANSAS CITY, MO
    ZIP 64111
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHYLLIS IDUN
  • NPI Number: 1588764922
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D2225294
LAB Type Pharmacy
Facility Name MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #05697
Street 3902 MAIN ST
City KANSAS CITY
State MO
ZIP 64111
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Pharmacy
Lab Director PHYLLIS IDUN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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