15D2049952 CLIA NUMBER - WALGREENS #12109

Laboratory Demographics

  • CLIA Code: 15D2049952
  • Facility Name: WALGREENS #12109
  • Facility Address: 7236 CALUMET AVE
    HAMMOND, IN
    ZIP 46324
  • Facility Phone: 219 937-0337
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OMAR M. MOHIUDDIN
  • NPI Number: 1588679690
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2049952
LAB Type Pharmacy
Facility Name WALGREENS #12109
Street 7236 CALUMET AVE
City HAMMOND
State IN
ZIP 46324
Phone 219 937-0337
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 OMAR M. MOHIUDDIN

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