36D2195839 CLIA NUMBER - MEDICINE SHOPPE #1202, THE

Laboratory Demographics

  • CLIA Code: 36D2195839
  • Facility Name: MEDICINE SHOPPE #1202, THE
  • Facility Address: 821 SCIOTO ST
    URBANA, OH
    ZIP 43078
  • Facility Phone: 937 653-3914
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRYAN C. THOMPSON
  • NPI Number: 1295890614
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2195839
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE #1202, THE
Street 821 SCIOTO ST
City URBANA
State OH
ZIP 43078
Phone 937 653-3914
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2024
Certificate Expiration Date 10/12/2026
Facility Type Pharmacy
Lab Director BRYAN C. THOMPSON

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