15D2025305 CLIA NUMBER - WALGREENS #03232

Laboratory Demographics

  • CLIA Code: 15D2025305
  • Facility Name: WALGREENS #03232
  • Facility Address: 429 W PIKE ST
    GOSHEN, IN
    ZIP 46526
  • Facility Phone: 574 534-7616
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SEAN E. OSHEA
  • NPI Number: 1699780734
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2025305
LAB Type Pharmacy
Facility Name WALGREENS #03232
Street 429 W PIKE ST
City GOSHEN
State IN
ZIP 46526
Phone 574 534-7616
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director SEAN E. OSHEA

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This page was last updated on: 3/20/2025