15D2215048 CLIA NUMBER - GLOTZBACH PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 15D2215048
  • Facility Name: GLOTZBACH PHARMACY LLC
  • Facility Address: 500 S GRANT AVE
    FOWLER, IN
    ZIP 47944
  • Facility Phone: 765 884-1520
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA M. GLOTZBACH
  • NPI Number: 1437507340
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2215048
LAB Type Pharmacy
Facility Name GLOTZBACH PHARMACY LLC
Street 500 S GRANT AVE
City FOWLER
State IN
ZIP 47944
Phone 765 884-1520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Pharmacy
Lab Director ANGELA M. GLOTZBACH

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