15D2038387 CLIA NUMBER - WALGREENS #11494

Laboratory Demographics

  • CLIA Code: 15D2038387
  • Facility Name: WALGREENS #11494
  • Facility Address: 124 E NORTH STREET
    KENDALLVILLE, IN
    ZIP 46755
  • Facility Phone: 260 349-1530
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: ADAM WOODARD
  • NPI Number: 1417101247
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2038387
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #11494
Street 124 E NORTH STREET
City KENDALLVILLE
State IN
ZIP 46755
Phone 260 349-1530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director ADAM WOODARD

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