49D2192982 CLIA NUMBER - THE MEDICINE SHOPPE #1177

Laboratory Demographics

  • CLIA Code: 49D2192982
  • Facility Name: THE MEDICINE SHOPPE #1177
  • Facility Address: 9893 GENERAL PULLER HIGHWAY
    HARTFIELD, VA
    ZIP 23071
  • Facility Phone: 804 776-9990
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAROLL A. THROCKMORTON
  • NPI Number: 1487726014
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2192982
LAB Type Pharmacy
Facility Name THE MEDICINE SHOPPE #1177
Street 9893 GENERAL PULLER HIGHWAY
City HARTFIELD
State VA
ZIP 23071
Phone 804 776-9990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Pharmacy
Lab Director CAROLL A. THROCKMORTON

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