15D2011438 CLIA NUMBER - WALGREENS #04592

Laboratory Demographics

  • CLIA Code: 15D2011438
  • Facility Name: WALGREENS #04592
  • Facility Address: 700 US HIGHWAY 31 S
    GREENWOOD, IN
    ZIP 46143
  • Facility Phone: 317 883-0567
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRENT D. CHAPPELL
  • NPI Number: 1346255486
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011438
LAB Type Pharmacy
Facility Name WALGREENS #04592
Street 700 US HIGHWAY 31 S
City GREENWOOD
State IN
ZIP 46143
Phone 317 883-0567
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Pharmacy
Lab Director TRENT D. CHAPPELL

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