15D1046841 CLIA NUMBER - IU HEALTH BALL MEMORIAL - LIBERTY CORNER

Laboratory Demographics

CLIA Number: 15D1046841

Facility Name: IU HEALTH BALL MEMORIAL - LIBERTY CORNER

Facility Address:
4870 E JACKSON ST
MUNCIE, IN
ZIP 47303
Get Directions

Facility Phone Number: 765 287-8596

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902900954

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	15D1046841
LAB Type	Physician Office
Facility Name	IU HEALTH BALL MEMORIAL - LIBERTY CORNER
Street	4870 E JACKSON ST
City	MUNCIE
State	IN
ZIP	47303
Phone	765 287-8596
CertificateType	4
CertificateEffectiveDate	1/18/2023
CertificateExpirationDate	1/17/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024