36D0987602 CLIA NUMBER - MEIJER PHARMACY #107

Laboratory Demographics

  • CLIA Code: 36D0987602
  • Facility Name: MEIJER PHARMACY #107
  • Facility Address: 3822 COLONEL GLENN HWY
    FAIRBORN, OH
    ZIP 45324
  • Facility Phone: 937 426-3600
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1265597041
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D0987602
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #107
Street 3822 COLONEL GLENN HWY
City FAIRBORN
State OH
ZIP 45324
Phone 937 426-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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