15D2112471 CLIA NUMBER - MEIJER PHARMACY #290

Laboratory Demographics

  • CLIA Code: 15D2112471
  • Facility Name: MEIJER PHARMACY #290
  • Facility Address: 5550 N KEYSTONE AVE
    INDIANAPOLIS, IN
    ZIP 46220
  • Facility Phone: 317 610-2210
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE MORSE
  • NPI Number: 1629439583
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2112471
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #290
Street 5550 N KEYSTONE AVE
City INDIANAPOLIS
State IN
ZIP 46220
Phone 317 610-2210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Pharmacy
Lab Director JACQUELINE MORSE

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