15D1008261 CLIA NUMBER - MEIJER PHARMACY #165

Laboratory Demographics

  • CLIA Code: 15D1008261
  • Facility Name: MEIJER PHARMACY #165
  • Facility Address: 611 US 30
    MERRILLVILLE, IN
    ZIP 46410
  • Facility Phone: 219 650-3710
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1083985956
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1008261
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #165
Street 611 US 30
City MERRILLVILLE
State IN
ZIP 46410
Phone 219 650-3710
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