15D1033291 CLIA NUMBER - OSCO DRUG #1189

Laboratory Demographics

  • CLIA Code: 15D1033291
  • Facility Name: OSCO DRUG #1189
  • Facility Address: 747 INDIAN BOUNDARY RD
    CHESTERTON, IN
    ZIP 46304
  • Facility Phone: 219 926-8723
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW SIEMIAWSKI
  • NPI Number: 1396791828
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1033291
LAB Type Pharmacy
Facility Name OSCO DRUG #1189
Street 747 INDIAN BOUNDARY RD
City CHESTERTON
State IN
ZIP 46304
Phone 219 926-8723
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Pharmacy
Lab Director MATTHEW SIEMIAWSKI

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