15D2025045 CLIA NUMBER - WALGREENS #09318

Laboratory Demographics

  • CLIA Code: 15D2025045
  • Facility Name: WALGREENS #09318
  • Facility Address: 525 E LINCOLNWAY
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 326-9536
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN R. HEROD
  • NPI Number: 1689681629
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2025045
LAB Type Pharmacy
Facility Name WALGREENS #09318
Street 525 E LINCOLNWAY
City LA PORTE
State IN
ZIP 46350
Phone 219 326-9536
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Pharmacy
Lab Director JOHN R. HEROD

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