44D2008655 CLIA NUMBER - MAC'S PHARMACY #2 LLC DBA MAC'S EDGEMOOR PHARMACY

Laboratory Demographics

  • CLIA Code: 44D2008655
  • Facility Name: MAC'S PHARMACY #2 LLC DBA MAC'S EDGEMOOR PHARMACY
  • Facility Address: 643 EDGEMOOR RD
    POWELL, TN
    ZIP 37849
  • Facility Phone: 865 945-3333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. WILHOIT
  • NPI Number: 1346510708
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2008655
LAB Type Pharmacy
Facility Name MAC'S PHARMACY #2 LLC DBA MAC'S EDGEMOOR PHARMACY
Street 643 EDGEMOOR RD
City POWELL
State TN
ZIP 37849
Phone 865 945-3333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Pharmacy
Lab Director MICHAEL S. WILHOIT

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