15D2011477 CLIA NUMBER - WALGREENS #05753

Laboratory Demographics

  • CLIA Code: 15D2011477
  • Facility Name: WALGREENS #05753
  • Facility Address: 7975 E US HIGHWAY 36
    AVON, IN
    ZIP 46123
  • Facility Phone: 317 272-5563
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULIANNE R. COOK
  • NPI Number: 1497760532
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011477
LAB Type Pharmacy
Facility Name WALGREENS #05753
Street 7975 E US HIGHWAY 36
City AVON
State IN
ZIP 46123
Phone 317 272-5563
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2023
Certificate Expiration Date 7/21/2025
Facility Type Pharmacy
Lab Director JULIANNE R. COOK

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This page was last updated on: 6/4/2025