15D1077782 CLIA NUMBER - SCOTTS PHARMACY 424

Laboratory Demographics

  • CLIA Code: 15D1077782
  • Facility Name: SCOTTS PHARMACY 424
  • Facility Address: 10230 CHESTNUT PLAZA DR
    FORT WAYNE, IN
    ZIP 46814
  • Facility Phone: 260 625-5949
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAMS WEBER
  • NPI Number: 1679778989
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D1077782
LAB Type Pharmacy
Facility Name SCOTTS PHARMACY 424
Street 10230 CHESTNUT PLAZA DR
City FORT WAYNE
State IN
ZIP 46814
Phone 260 625-5949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Pharmacy
Lab Director WILLIAMS WEBER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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