15D2059266 CLIA NUMBER - WALGREENS #10123

Laboratory Demographics

  • CLIA Code: 15D2059266
  • Facility Name: WALGREENS #10123
  • Facility Address: 10795 BROADWAY
    CROWN POINT, IN
    ZIP 46307
  • Facility Phone: 219 661-8406
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANASTASIOS J. SAKALEROS
  • NPI Number: 1891808663
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2059266
LAB Type Pharmacy
Facility Name WALGREENS #10123
Street 10795 BROADWAY
City CROWN POINT
State IN
ZIP 46307
Phone 219 661-8406
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2023
Certificate Expiration Date 9/2/2025
Facility Type Pharmacy
Lab Director ANASTASIOS J. SAKALEROS

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