15D0972087 CLIA NUMBER - MEIJER PHARMACY #128

Laboratory Demographics

  • CLIA Code: 15D0972087
  • Facility Name: MEIJER PHARMACY #128
  • Facility Address: 3610 S BREMEN HWY
    MISHAWAKA, IN
    ZIP 46544
  • Facility Phone: 574 254-2510
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1477823276
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D0972087
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #128
Street 3610 S BREMEN HWY
City MISHAWAKA
State IN
ZIP 46544
Phone 574 254-2510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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