15D2038385 CLIA NUMBER - WALGREENS #05510

Laboratory Demographics

  • CLIA Code: 15D2038385
  • Facility Name: WALGREENS #05510
  • Facility Address: 9030 US HIGHWAY 24 W
    FORT WAYNE, IN
    ZIP 46804
  • Facility Phone: 260 432-7413
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDRA LIJEWSKI
  • NPI Number: 1134134265
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2038385
LAB Type Pharmacy
Facility Name WALGREENS #05510
Street 9030 US HIGHWAY 24 W
City FORT WAYNE
State IN
ZIP 46804
Phone 260 432-7413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Pharmacy
Lab Director ALEXANDRA LIJEWSKI

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