15D2011425 CLIA NUMBER - WALGREENS #07174

Laboratory Demographics

  • CLIA Code: 15D2011425
  • Facility Name: WALGREENS #07174
  • Facility Address: 1195 N STATE ST
    GREENFIELD, IN
    ZIP 46140
  • Facility Phone: 317 462-8923
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAYCE P. BROWN
  • NPI Number: 1336154483
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011425
LAB Type Pharmacy
Facility Name WALGREENS #07174
Street 1195 N STATE ST
City GREENFIELD
State IN
ZIP 46140
Phone 317 462-8923
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 JAYCE P. BROWN

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