15D2011471 CLIA NUMBER - WALGREENS #06455

Laboratory Demographics

  • CLIA Code: 15D2011471
  • Facility Name: WALGREENS #06455
  • Facility Address: 115 FIELDS ST
    MOORESVILLE, IN
    ZIP 46158
  • Facility Phone: 317 834-6678
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JINNY MYERS
  • NPI Number: 1073528113
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2011471
LAB Type Pharmacy
Facility Name WALGREENS #06455
Street 115 FIELDS ST
City MOORESVILLE
State IN
ZIP 46158
Phone 317 834-6678
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 JINNY MYERS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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