15D2037710 CLIA NUMBER - WALGREENS #10073

Laboratory Demographics

  • CLIA Code: 15D2037710
  • Facility Name: WALGREENS #10073
  • Facility Address: 2400 W SYCAMORE ST
    KOKOMO, IN
    ZIP 46901
  • Facility Phone: 847 527-4238
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: BENJAMIN BRINGEDAHI
  • NPI Number: 1356497002
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2037710
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #10073
Street 2400 W SYCAMORE ST
City KOKOMO
State IN
ZIP 46901
Phone 847 527-4238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director BENJAMIN BRINGEDAHI

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