15D1008315 CLIA NUMBER - MEIJER PHARMACY 124

Laboratory Demographics

  • CLIA Code: 15D1008315
  • Facility Name: MEIJER PHARMACY 124
  • Facility Address: 6309 LIMA RD
    FORT WAYNE, IN
    ZIP 46818
  • Facility Phone: 260 498-1010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1578834974
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1008315
LAB Type Pharmacy
Facility Name MEIJER PHARMACY 124
Street 6309 LIMA RD
City FORT WAYNE
State IN
ZIP 46818
Phone 260 498-1010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2025
Certificate Expiration Date 1/15/2027
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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