36D2183811 CLIA NUMBER - WANDAROO INC DBA THE HOMETOWN PHARMACY

Laboratory Demographics

  • CLIA Code: 36D2183811
  • Facility Name: WANDAROO INC DBA THE HOMETOWN PHARMACY
  • Facility Address: 1135 WESTERN RESERVE RD
    POLAND, OH
    ZIP 44514
  • Facility Phone: 330 318-3926
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARCIA KEELER
  • NPI Number: 1376167908
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2183811
LAB Type Pharmacy
Facility Name WANDAROO INC DBA THE HOMETOWN PHARMACY
Street 1135 WESTERN RESERVE RD
City POLAND
State OH
ZIP 44514
Phone 330 318-3926
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2024
Certificate Expiration Date 5/10/2026
Facility Type Pharmacy
Lab Director MARCIA KEELER

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