15D2030271 CLIA NUMBER - WALGREENS #9826

Laboratory Demographics

  • CLIA Code: 15D2030271
  • Facility Name: WALGREENS #9826
  • Facility Address: 9 N STATE ST
    NORTH VERNON, IN
    ZIP 47265
  • Facility Phone: 812 346-4834
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY FERGUSON
  • NPI Number: 1962455923
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2030271
LAB Type Pharmacy
Facility Name WALGREENS #9826
Street 9 N STATE ST
City NORTH VERNON
State IN
ZIP 47265
Phone 812 346-4834
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Pharmacy
Lab Director KELLY FERGUSON

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