36D2183440 CLIA NUMBER - MEDICINE SHOPPE 2000, LLC

Laboratory Demographics

  • CLIA Code: 36D2183440
  • Facility Name: MEDICINE SHOPPE 2000, LLC
  • Facility Address: 114 N MAIN STREET
    BALTIMORE, OH
    ZIP 43105
  • Facility Phone: 740 862-4240
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. TAMER F. IBRAHIM
  • NPI Number: 1609889575
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2183440
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE 2000, LLC
Street 114 N MAIN STREET
City BALTIMORE
State OH
ZIP 43105
Phone 740 862-4240
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