35D0987815 CLIA NUMBER - MEDICINE SHOPPE PHARMACY, THE

Laboratory Demographics

  • CLIA Code: 35D0987815
  • Facility Name: MEDICINE SHOPPE PHARMACY, THE
  • Facility Address: 2800 N BROADWAY
    FARGO, ND
    ZIP 58102
  • Facility Phone: 701 293-0221
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROSS M. WILHELM
  • NPI Number: 1447362454
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 35D0987815
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE PHARMACY, THE
Street 2800 N BROADWAY
City FARGO
State ND
ZIP 58102
Phone 701 293-0221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Pharmacy
Lab Director ROSS M. WILHELM

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