14D2255423 CLIA NUMBER - SHIELDS FAMILY PHARMACY

Laboratory Demographics

  • CLIA Code: 14D2255423
  • Facility Name: SHIELDS FAMILY PHARMACY
  • Facility Address: 1 PROFESSIONAL DR - STE 170
    ALTON, IL
    ZIP 62002
  • Facility Phone: 618 463-0000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SETH K. ANATO
  • NPI Number: 1982001996
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2255423
LAB Type Pharmacy
Facility Name SHIELDS FAMILY PHARMACY
Street 1 PROFESSIONAL DR - STE 170
City ALTON
State IL
ZIP 62002
Phone 618 463-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Pharmacy
Lab Director SETH K. ANATO

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This page was last updated on: 3/20/2025