15D2011420 CLIA NUMBER - WALGREENS #15032

Laboratory Demographics

  • CLIA Code: 15D2011420
  • Facility Name: WALGREENS #15032
  • Facility Address: 1290 N STATE RD 135
    GREENWOOD, IN
    ZIP 46142
  • Facility Phone: 317 865-0472
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIGNASA J. DHOLARIA
  • NPI Number: 1679588701
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011420
LAB Type Pharmacy
Facility Name WALGREENS #15032
Street 1290 N STATE RD 135
City GREENWOOD
State IN
ZIP 46142
Phone 317 865-0472
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director JIGNASA J. DHOLARIA

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