36D0960791 CLIA NUMBER - PHILLY PHARMACY INC

Laboratory Demographics

  • CLIA Code: 36D0960791
  • Facility Name: PHILLY PHARMACY INC
  • Facility Address: 551 W HIGH AVENUE
    NEW PHILADELPHIA, OH
    ZIP 44663
  • Facility Phone: 330 339-4466
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRAD WHITE
  • NPI Number: 1205927746
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D0960791
LAB Type Pharmacy
Facility Name PHILLY PHARMACY INC
Street 551 W HIGH AVENUE
City NEW PHILADELPHIA
State OH
ZIP 44663
Phone 330 339-4466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Pharmacy
Lab Director BRAD WHITE

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