15D2011429 CLIA NUMBER - WALGREENS #03609

Laboratory Demographics

  • CLIA Code: 15D2011429
  • Facility Name: WALGREENS #03609
  • Facility Address: 5095 E THOMPSON RD
    INDIANAPOLIS, IN
    ZIP 46237
  • Facility Phone: 317 783-6547
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATT R. ASHBROCK
  • NPI Number: 1871508911
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011429
LAB Type Pharmacy
Facility Name WALGREENS #03609
Street 5095 E THOMPSON RD
City INDIANAPOLIS
State IN
ZIP 46237
Phone 317 783-6547
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Pharmacy
Lab Director MATT R. ASHBROCK

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