15D2047249 CLIA NUMBER - WALGREENS #11945

Laboratory Demographics

  • CLIA Code: 15D2047249
  • Facility Name: WALGREENS #11945
  • Facility Address: 11932 LIMA RD
    FORT WAYNE, IN
    ZIP 46818
  • Facility Phone: 260 637-6667
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICK SHANNON
  • NPI Number: 1063678209
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2047249
LAB Type Pharmacy
Facility Name WALGREENS #11945
Street 11932 LIMA RD
City FORT WAYNE
State IN
ZIP 46818
Phone 260 637-6667
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Pharmacy
Lab Director PATRICK SHANNON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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