15D2038377 CLIA NUMBER - WALGREENS 09321

Laboratory Demographics

  • CLIA Code: 15D2038377
  • Facility Name: WALGREENS 09321
  • Facility Address: 710 N SAINT JOSEPH AVE
    EVANSVILLE, IN
    ZIP 47712
  • Facility Phone: 812 426-1180
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BLAINE M. GOOCH
  • NPI Number: 1497760524
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2038377
LAB Type Pharmacy
Facility Name WALGREENS 09321
Street 710 N SAINT JOSEPH AVE
City EVANSVILLE
State IN
ZIP 47712
Phone 812 426-1180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Pharmacy
Lab Director BLAINE M. GOOCH

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