34D0952662 CLIA NUMBER - MOOSE PROFESSIONAL PHARMACY

Laboratory Demographics

  • CLIA Code: 34D0952662
  • Facility Name: MOOSE PROFESSIONAL PHARMACY
  • Facility Address: 740 CHURCH ST
    CONCORD, NC
    ZIP 28025
  • Facility Phone: 704 784-9613
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH S. MOOSE
  • NPI Number: 1043317027
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D0952662
LAB Type Pharmacy
Facility Name MOOSE PROFESSIONAL PHARMACY
Street 740 CHURCH ST
City CONCORD
State NC
ZIP 28025
Phone 704 784-9613
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Pharmacy
Lab Director JOSEPH S. MOOSE

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