26D2225301 CLIA NUMBER - MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #5693

Laboratory Demographics

  • CLIA Code: 26D2225301
  • Facility Name: MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #5693
  • Facility Address: 8421 NW PRAIRIE VIEW RD
    KANSAS CITY, MO
    ZIP 64153
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEL ROUDEBUSH
  • NPI Number: 1851490163
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2225301
LAB Type Pharmacy
Facility Name MISSOURI CVS PHARMACY, LLC DBA CVS/PHARMACY #5693
Street 8421 NW PRAIRIE VIEW RD
City KANSAS CITY
State MO
ZIP 64153
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 KEL ROUDEBUSH

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