15D1008258 CLIA NUMBER - MEIJER PHARMACY #190

Laboratory Demographics

  • CLIA Code: 15D1008258
  • Facility Name: MEIJER PHARMACY #190
  • Facility Address: 2990 N WAYNE ST
    ANGOLA, IN
    ZIP 46703
  • Facility Phone: 260 668-1110
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1912278243
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1008258
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #190
Street 2990 N WAYNE ST
City ANGOLA
State IN
ZIP 46703
Phone 260 668-1110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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