15D2058790 CLIA NUMBER - WALGREENS #10487

Laboratory Demographics

  • CLIA Code: 15D2058790
  • Facility Name: WALGREENS #10487
  • Facility Address: 6745 EAST SOUTHPORT ROAD
    INDIANAPOLIS, IN
    ZIP 46237
  • Facility Phone: 317 887-0691
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: MATT BEACH
  • NPI Number: 1669683355
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2058790
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #10487
Street 6745 EAST SOUTHPORT ROAD
City INDIANAPOLIS
State IN
ZIP 46237
Phone 317 887-0691
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director MATT BEACH

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