15D1004046 CLIA NUMBER - HERBST APOTHECARY

Laboratory Demographics

  • CLIA Code: 15D1004046
  • Facility Name: HERBST APOTHECARY
  • Facility Address: 201 N DIXON RD
    KOKOMO, IN
    ZIP 46901
  • Facility Phone: 765 457-1191
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATHLEEN J. CONDO
  • NPI Number: 1255822409
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1004046
LAB Type Pharmacy
Facility Name HERBST APOTHECARY
Street 201 N DIXON RD
City KOKOMO
State IN
ZIP 46901
Phone 765 457-1191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Pharmacy
Lab Director KATHLEEN J. CONDO

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