15D2011530 CLIA NUMBER - WALGREENS #05787

Laboratory Demographics

  • CLIA Code: 15D2011530
  • Facility Name: WALGREENS #05787
  • Facility Address: 651 W US HWY 30
    SCHERERVILLE, IN
    ZIP 46375
  • Facility Phone: 219 865-2245
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD K. BACH
  • NPI Number: 1487669503
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011530
LAB Type Pharmacy
Facility Name WALGREENS #05787
Street 651 W US HWY 30
City SCHERERVILLE
State IN
ZIP 46375
Phone 219 865-2245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director RICHARD K. BACH

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