15D2053408 CLIA NUMBER - WALGREENS #09711

Laboratory Demographics

  • CLIA Code: 15D2053408
  • Facility Name: WALGREENS #09711
  • Facility Address: 2040 LAFAYETTE AVE
    TERRE HAUTE, IN
    ZIP 47805
  • Facility Phone: 812 466-7536
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER T. WAKEFIELD
  • NPI Number: 1326053471
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2053408
LAB Type Pharmacy
Facility Name WALGREENS #09711
Street 2040 LAFAYETTE AVE
City TERRE HAUTE
State IN
ZIP 47805
Phone 812 466-7536
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 CHRISTOPHER T. WAKEFIELD

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