36D0034062 CLIA NUMBER - HENDERSON PHARM SERV INC DBA MED SHOP #749

Laboratory Demographics

  • CLIA Code: 36D0034062
  • Facility Name: HENDERSON PHARM SERV INC DBA MED SHOP #749
  • Facility Address: 186 W MAIN ST
    CHILLICOTHE, OH
    ZIP 45601
  • Facility Phone: 614 775-1181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RONALD W. HENDERSON
  • NPI Number: 1962570945
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D0034062
LAB Type Pharmacy
Facility Name HENDERSON PHARM SERV INC DBA MED SHOP #749
Street 186 W MAIN ST
City CHILLICOTHE
State OH
ZIP 45601
Phone 614 775-1181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Pharmacy
Lab Director RONALD W. HENDERSON

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