15D2059746 CLIA NUMBER - MEIJER PHARMACY #266

Laboratory Demographics

  • CLIA Code: 15D2059746
  • Facility Name: MEIJER PHARMACY #266
  • Facility Address: 6050 US HWY 6
    PORTAGE, IN
    ZIP 46368
  • Facility Phone: 219 763-0310
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON BEAUCH
  • NPI Number: 1457796542
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2059746
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #266
Street 6050 US HWY 6
City PORTAGE
State IN
ZIP 46368
Phone 219 763-0310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Pharmacy
Lab Director JASON BEAUCH

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