15D2230125 CLIA NUMBER - WALGREENS #05727

Laboratory Demographics

  • CLIA Code: 15D2230125
  • Facility Name: WALGREENS #05727
  • Facility Address: 13242 WICKER AVE
    CEDAR LAKE, IN
    ZIP 46303
  • Facility Phone: 219 374-9346
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GINA S. BENDER
  • NPI Number: 1770598815
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2230125
LAB Type Pharmacy
Facility Name WALGREENS #05727
Street 13242 WICKER AVE
City CEDAR LAKE
State IN
ZIP 46303
Phone 219 374-9346
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Pharmacy
Lab Director GINA S. BENDER

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