15D2011481 CLIA NUMBER - WALGREENS #04371

Laboratory Demographics

  • CLIA Code: 15D2011481
  • Facility Name: WALGREENS #04371
  • Facility Address: 1801 SOUTH ST
    LAFAYETTE, IN
    ZIP 47904
  • Facility Phone: 765 448-1366
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSEY M. MARTIN
  • NPI Number: 1316952450
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011481
LAB Type Pharmacy
Facility Name WALGREENS #04371
Street 1801 SOUTH ST
City LAFAYETTE
State IN
ZIP 47904
Phone 765 448-1366
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Pharmacy
Lab Director LINDSEY M. MARTIN

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