15D2011023 CLIA NUMBER - WALGREENS #06944

Laboratory Demographics

  • CLIA Code: 15D2011023
  • Facility Name: WALGREENS #06944
  • Facility Address: 3608 S LA FOUNTAIN ST
    KOKOMO, IN
    ZIP 46902
  • Facility Phone: 765 455-2191
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LESIA M. MOORE
  • NPI Number: 1245245380
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011023
LAB Type Pharmacy
Facility Name WALGREENS #06944
Street 3608 S LA FOUNTAIN ST
City KOKOMO
State IN
ZIP 46902
Phone 765 455-2191
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 LESIA M. MOORE

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