15D2224427 CLIA NUMBER - WALGREENS #10529

Laboratory Demographics

  • CLIA Code: 15D2224427
  • Facility Name: WALGREENS #10529
  • Facility Address: 2123 E COLUMBUS DR
    EAST CHICAGO, IN
    ZIP 46312
  • Facility Phone: 219 397-6911
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY COSTELLO
  • NPI Number: 1659386761
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2224427
LAB Type Pharmacy
Facility Name WALGREENS #10529
Street 2123 E COLUMBUS DR
City EAST CHICAGO
State IN
ZIP 46312
Phone 219 397-6911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Pharmacy
Lab Director KELLY COSTELLO

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