15D2031938 CLIA NUMBER - WALGREENS #10858

Laboratory Demographics

  • CLIA Code: 15D2031938
  • Facility Name: WALGREENS #10858
  • Facility Address: 130 S CREASY LN
    LAFAYETTE, IN
    ZIP 47905
  • Facility Phone: 765 448-3517
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIMMY H. RHOADES
  • NPI Number: 1386801512
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2031938
LAB Type Pharmacy
Facility Name WALGREENS #10858
Street 130 S CREASY LN
City LAFAYETTE
State IN
ZIP 47905
Phone 765 448-3517
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Pharmacy
Lab Director JIMMY H. RHOADES

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