36D2199938 CLIA NUMBER - WEDGEWOOD PHARMACY

Laboratory Demographics

  • CLIA Code: 36D2199938
  • Facility Name: WEDGEWOOD PHARMACY
  • Facility Address: 4350 NEW RD
    AUSTINTOWN, OH
    ZIP 44515
  • Facility Phone: 330 799-2503
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRAD P. VAUGHN
  • NPI Number: 1841831831
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2199938
LAB Type Pharmacy
Facility Name WEDGEWOOD PHARMACY
Street 4350 NEW RD
City AUSTINTOWN
State OH
ZIP 44515
Phone 330 799-2503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Pharmacy
Lab Director BRAD P. VAUGHN

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