36D1051118 CLIA NUMBER - DISCOUNT DRUG MART #63

Laboratory Demographics

  • CLIA Code: 36D1051118
  • Facility Name: DISCOUNT DRUG MART #63
  • Facility Address: 592 12TH STREET NORTHWEST
    CARROLLTON, OH
    ZIP 44615
  • Facility Phone: 330 627-9005
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID SVENSON
  • NPI Number: 1063448314
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1051118
LAB Type Pharmacy
Facility Name DISCOUNT DRUG MART #63
Street 592 12TH STREET NORTHWEST
City CARROLLTON
State OH
ZIP 44615
Phone 330 627-9005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Pharmacy
Lab Director DAVID SVENSON

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