50D2249267 CLIA NUMBER - SHELTON PHARMACY

Laboratory Demographics

  • CLIA Code: 50D2249267
  • Facility Name: SHELTON PHARMACY
  • Facility Address: 110 W K ST STE B
    SHELTON, WA
    ZIP 98584
  • Facility Phone: 360 545-4333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SRINIVASA RAO TUMMALA
  • NPI Number: 1801244504
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2249267
LAB Type Pharmacy
Facility Name SHELTON PHARMACY
Street 110 W K ST STE B
City SHELTON
State WA
ZIP 98584
Phone 360 545-4333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2022
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SRINIVASA RAO TUMMALA

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