15D2011015 CLIA NUMBER - WALGREENS #05802

Laboratory Demographics

  • CLIA Code: 15D2011015
  • Facility Name: WALGREENS #05802
  • Facility Address: 100 E MCGALLIARD RD
    MUNCIE, IN
    ZIP 47303
  • Facility Phone: 765 288-6171
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN P. YAGER
  • NPI Number: 1215944210
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011015
LAB Type Pharmacy
Facility Name WALGREENS #05802
Street 100 E MCGALLIARD RD
City MUNCIE
State IN
ZIP 47303
Phone 765 288-6171
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 JUSTIN P. YAGER

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