15D2038378 CLIA NUMBER - WALGREENS #06868

Laboratory Demographics

  • CLIA Code: 15D2038378
  • Facility Name: WALGREENS #06868
  • Facility Address: 330 W STATE BLVD
    FORT WAYNE, IN
    ZIP 46808
  • Facility Phone: 260 482-5428
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW J. SCHAFER
  • NPI Number: 1043225170
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2038378
LAB Type Pharmacy
Facility Name WALGREENS #06868
Street 330 W STATE BLVD
City FORT WAYNE
State IN
ZIP 46808
Phone 260 482-5428
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2025
Certificate Expiration Date 5/26/2027
Facility Type Pharmacy
Lab Director MATTHEW J. SCHAFER

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