15D2282853 CLIA NUMBER - HOOK-SUPERX LLC DBA CVS/PHARMACY #01658

Laboratory Demographics

  • CLIA Code: 15D2282853
  • Facility Name: HOOK-SUPERX LLC DBA CVS/PHARMACY #01658
  • Facility Address: 1074 N STATE RD 267
    AVON, IN
    ZIP 46123
  • Facility Phone: 317 272-2133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BEVERLY BORTZ
  • NPI Number: 1235236720
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2282853
LAB Type Pharmacy
Facility Name HOOK-SUPERX LLC DBA CVS/PHARMACY #01658
Street 1074 N STATE RD 267
City AVON
State IN
ZIP 46123
Phone 317 272-2133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director BEVERLY BORTZ

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