15D2224669 CLIA NUMBER - WALGREENS #12812

Laboratory Demographics

  • CLIA Code: 15D2224669
  • Facility Name: WALGREENS #12812
  • Facility Address: 1520 S COURT STREET
    CROWN POINT, IN
    ZIP 46307
  • Facility Phone: 219 663-0336
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MINDY L. KEETON
  • NPI Number: 1013924000
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2224669
LAB Type Pharmacy
Facility Name WALGREENS #12812
Street 1520 S COURT STREET
City CROWN POINT
State IN
ZIP 46307
Phone 219 663-0336
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director MINDY L. KEETON

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