15D2230365 CLIA NUMBER - CLOVERDALE DRUGS

Laboratory Demographics

  • CLIA Code: 15D2230365
  • Facility Name: CLOVERDALE DRUGS
  • Facility Address: 900 N MAIN ST
    CLOVERDALE, IN
    ZIP 46120
  • Facility Phone: 765 795-4100
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNEDY RYAN
  • NPI Number: 1780788927
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2230365
LAB Type Pharmacy
Facility Name CLOVERDALE DRUGS
Street 900 N MAIN ST
City CLOVERDALE
State IN
ZIP 46120
Phone 765 795-4100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Pharmacy
Lab Director KENNEDY RYAN

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