15D2011536 CLIA NUMBER - WALGREENS #04462

Laboratory Demographics

  • CLIA Code: 15D2011536
  • Facility Name: WALGREENS #04462
  • Facility Address: 6510 COLUMBIA AVE
    HAMMOND, IN
    ZIP 46320
  • Facility Phone: 219 931-3332
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES J. KAPTUR
  • NPI Number: 1295742286
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2011536
LAB Type Pharmacy
Facility Name WALGREENS #04462
Street 6510 COLUMBIA AVE
City HAMMOND
State IN
ZIP 46320
Phone 219 931-3332
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Pharmacy
Lab Director JAMES J. KAPTUR

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