15D2037741 CLIA NUMBER - WALGREENS #21380

Laboratory Demographics

  • CLIA Code: 15D2037741
  • Facility Name: WALGREENS #21380
  • Facility Address: 865 S COLLEGE AVE
    RENSSELAER, IN
    ZIP 47978
  • Facility Phone: 219 866-4156
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF A. DANGELO
  • NPI Number: 1114932233
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2037741
LAB Type Pharmacy
Facility Name WALGREENS #21380
Street 865 S COLLEGE AVE
City RENSSELAER
State IN
ZIP 47978
Phone 219 866-4156
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 JEFF A. DANGELO

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