15D2059260 CLIA NUMBER - WALGREENS #15116

Laboratory Demographics

  • CLIA Code: 15D2059260
  • Facility Name: WALGREENS #15116
  • Facility Address: 5580 GEORGETOWN RD
    INDIANAPOLIS, IN
    ZIP 46254
  • Facility Phone: 317 297-1777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUDRA D. WITHERS
  • NPI Number: 1144560012
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2059260
LAB Type Pharmacy
Facility Name WALGREENS #15116
Street 5580 GEORGETOWN RD
City INDIANAPOLIS
State IN
ZIP 46254
Phone 317 297-1777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Pharmacy
Lab Director AUDRA D. WITHERS

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This page was last updated on: 6/4/2025