15D1076914 CLIA NUMBER - PAYLESS PHARMACY 827

Laboratory Demographics

  • CLIA Code: 15D1076914
  • Facility Name: PAYLESS PHARMACY 827
  • Facility Address: 2513 MAPLE POINT DR
    LAFAYETTE, IN
    ZIP 47905
  • Facility Phone: 765 447-8337
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE GILMORE
  • NPI Number: 1730252255
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1076914
LAB Type Pharmacy
Facility Name PAYLESS PHARMACY 827
Street 2513 MAPLE POINT DR
City LAFAYETTE
State IN
ZIP 47905
Phone 765 447-8337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Pharmacy
Lab Director NICOLE GILMORE

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