15D2011473 CLIA NUMBER - WALGREENS #06778

Laboratory Demographics

  • CLIA Code: 15D2011473
  • Facility Name: WALGREENS #06778
  • Facility Address: 6191 N KEYSTONE AVE
    INDIANAPOLIS, IN
    ZIP 46220
  • Facility Phone: 317 257-6746
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TARA HOYLE
  • NPI Number: 1336154475
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011473
LAB Type Pharmacy
Facility Name WALGREENS #06778
Street 6191 N KEYSTONE AVE
City INDIANAPOLIS
State IN
ZIP 46220
Phone 317 257-6746
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 TARA HOYLE

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