36D2183438 CLIA NUMBER - MEDICINE SHOPPE 1088, LLC

Laboratory Demographics

  • CLIA Code: 36D2183438
  • Facility Name: MEDICINE SHOPPE 1088, LLC
  • Facility Address: 345 N SANDUSKY AVE
    BUCYRUS, OH
    ZIP 44820
  • Facility Phone: 419 562-4222
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. TAMER F. IBRAHIM
  • NPI Number: 1255932349
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2183438
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE 1088, LLC
Street 345 N SANDUSKY AVE
City BUCYRUS
State OH
ZIP 44820
Phone 419 562-4222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2024
Certificate Expiration Date 5/4/2026
Facility Type Pharmacy
Lab Director MR. TAMER F. IBRAHIM

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