15D2011457 CLIA NUMBER - WALGREENS #07676

Laboratory Demographics

  • CLIA Code: 15D2011457
  • Facility Name: WALGREENS #07676
  • Facility Address: 1900 S OHIO ST
    MARTINSVILLE, IN
    ZIP 46151
  • Facility Phone: 765 349-2340
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRAVIS C. KLEINGARTNER
  • NPI Number: 1881609923
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011457
LAB Type Pharmacy
Facility Name WALGREENS #07676
Street 1900 S OHIO ST
City MARTINSVILLE
State IN
ZIP 46151
Phone 765 349-2340
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 TRAVIS C. KLEINGARTNER

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