15D2038873 CLIA NUMBER - WALGREENS #10149

Laboratory Demographics

  • CLIA Code: 15D2038873
  • Facility Name: WALGREENS #10149
  • Facility Address: 13741 E 116TH ST
    FISHERS, IN
    ZIP 46037
  • Facility Phone: 317 595-8764
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEREK L. STREETER
  • NPI Number: 1659324911
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2038873
LAB Type Pharmacy
Facility Name WALGREENS #10149
Street 13741 E 116TH ST
City FISHERS
State IN
ZIP 46037
Phone 317 595-8764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2025
Certificate Expiration Date 9/2/2027
Facility Type Pharmacy
Lab Director DEREK L. STREETER

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