15D2283104 CLIA NUMBER - HOOK-SUPERX, LLC DBA CVS/PHARMACY #06542

Laboratory Demographics

  • CLIA Code: 15D2283104
  • Facility Name: HOOK-SUPERX, LLC DBA CVS/PHARMACY #06542
  • Facility Address: 4026 S 00 EW
    KOKOMO, IN
    ZIP 46902
  • Facility Phone: 765 453-3979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH WAITT
  • NPI Number: 1801999503
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2283104
LAB Type Pharmacy
Facility Name HOOK-SUPERX, LLC DBA CVS/PHARMACY #06542
Street 4026 S 00 EW
City KOKOMO
State IN
ZIP 46902
Phone 765 453-3979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Pharmacy
Lab Director KENNETH WAITT

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