15D2023953 CLIA NUMBER - WALGREENS #04122

Laboratory Demographics

  • CLIA Code: 15D2023953
  • Facility Name: WALGREENS #04122
  • Facility Address: 2755 CHARLESTOWN RD
    NEW ALBANY, IN
    ZIP 47150
  • Facility Phone: 812 944-8859
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACK L. HARMON
  • NPI Number: 1831106822
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2023953
LAB Type Pharmacy
Facility Name WALGREENS #04122
Street 2755 CHARLESTOWN RD
City NEW ALBANY
State IN
ZIP 47150
Phone 812 944-8859
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Pharmacy
Lab Director JACK L. HARMON

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