15D2090788 CLIA NUMBER - KAUP PHARMACY

Laboratory Demographics

  • CLIA Code: 15D2090788
  • Facility Name: KAUP PHARMACY
  • Facility Address: 104 W MAIN STREET
    BERNE, IN
    ZIP 46711
  • Facility Phone: 260 589-3330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAWN R. GOODWIN
  • NPI Number: 1447655139
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2090788
LAB Type Pharmacy
Facility Name KAUP PHARMACY
Street 104 W MAIN STREET
City BERNE
State IN
ZIP 46711
Phone 260 589-3330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2025
Certificate Expiration Date 1/29/2027
Facility Type Pharmacy
Lab Director DAWN R. GOODWIN

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