15D2196609 CLIA NUMBER - VALLEY PHARMACY

Laboratory Demographics

  • CLIA Code: 15D2196609
  • Facility Name: VALLEY PHARMACY
  • Facility Address: 325 A N HALLECK ST
    DEMOTTE, IN
    ZIP 46310
  • Facility Phone: 219 987-3330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL L. SWART
  • NPI Number: 1861960353
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2196609
LAB Type Pharmacy
Facility Name VALLEY PHARMACY
Street 325 A N HALLECK ST
City DEMOTTE
State IN
ZIP 46310
Phone 219 987-3330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Pharmacy
Lab Director MICHAEL L. SWART

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