15D2058788 CLIA NUMBER - WALGREENS #05853

Laboratory Demographics

  • CLIA Code: 15D2058788
  • Facility Name: WALGREENS #05853
  • Facility Address: 720 STATE ROAD 135
    GREENWOOD, IN
    ZIP 46143
  • Facility Phone: 317 888-6917
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOLEEN B. SAWYER
  • NPI Number: 1336156371
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2058788
LAB Type Pharmacy
Facility Name WALGREENS #05853
Street 720 STATE ROAD 135
City GREENWOOD
State IN
ZIP 46143
Phone 317 888-6917
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director JOLEEN B. SAWYER

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