26D2307781 CLIA NUMBER - HOMETOWN PHARMACY #267

Laboratory Demographics

  • CLIA Code: 26D2307781
  • Facility Name: HOMETOWN PHARMACY #267
  • Facility Address: 606 EAST MOUNT VERNON BLVD
    MOUNT VERNON, MO
    ZIP 65712
  • Facility Phone: 417 466-2000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHELSEA DOHERTY
  • NPI Number: 1063513398
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2307781
LAB Type Pharmacy
Facility Name HOMETOWN PHARMACY #267
Street 606 EAST MOUNT VERNON BLVD
City MOUNT VERNON
State MO
ZIP 65712
Phone 417 466-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Pharmacy
Lab Director CHELSEA DOHERTY

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