34D1106695 CLIA NUMBER - INNOVATIVE MEDS RX, INC DBA GATES PHARMACY

Laboratory Demographics

  • CLIA Code: 34D1106695
  • Facility Name: INNOVATIVE MEDS RX, INC DBA GATES PHARMACY
  • Facility Address: 364 NORTH SOUTH STREET
    MOUNT AIRY, NC
    ZIP 27030
  • Facility Phone: 336 789-5050
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NEIL I. EDLEN
  • NPI Number: 1700154366
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D1106695
LAB Type Pharmacy
Facility Name INNOVATIVE MEDS RX, INC DBA GATES PHARMACY
Street 364 NORTH SOUTH STREET
City MOUNT AIRY
State NC
ZIP 27030
Phone 336 789-5050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Pharmacy
Lab Director NEIL I. EDLEN

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