15D2010981 CLIA NUMBER - WALGREENS #03129

Laboratory Demographics

  • CLIA Code: 15D2010981
  • Facility Name: WALGREENS #03129
  • Facility Address: 6201 STELLHORN RD
    FORT WAYNE, IN
    ZIP 46815
  • Facility Phone: 260 485-0755
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW SCHAFER
  • NPI Number: 1831104959
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2010981
LAB Type Pharmacy
Facility Name WALGREENS #03129
Street 6201 STELLHORN RD
City FORT WAYNE
State IN
ZIP 46815
Phone 260 485-0755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Pharmacy
Lab Director MATTHEW SCHAFER

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