34D2232342 CLIA NUMBER - OLD MAIN PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2232342
  • Facility Name: OLD MAIN PHARMACY
  • Facility Address: 407 WEST THIRD STREET
    PEMBROKE, NC
    ZIP 28372
  • Facility Phone: 910 521-5600
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SCOTT DONAGHY
  • NPI Number: 1649528613
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2232342
LAB Type Pharmacy
Facility Name OLD MAIN PHARMACY
Street 407 WEST THIRD STREET
City PEMBROKE
State NC
ZIP 28372
Phone 910 521-5600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Pharmacy
Lab Director SCOTT DONAGHY

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