15D1077745 CLIA NUMBER - SCOTTS PHARMACY #410

Laboratory Demographics

  • CLIA Code: 15D1077745
  • Facility Name: SCOTTS PHARMACY #410
  • Facility Address: 7008 BLUFFTON RD
    FORT WAYNE, IN
    ZIP 46809
  • Facility Phone: (260) 747-4136
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEYDA GRUEL-FIELDS
  • NPI Number: 1427253756
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1077745
LAB Type Pharmacy
Facility Name SCOTTS PHARMACY #410
Street 7008 BLUFFTON RD
City FORT WAYNE
State IN
ZIP 46809
Phone 2607474136
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Pharmacy
Lab Director JEYDA GRUEL-FIELDS

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This page was last updated on: 5/18/2026