15D2283118 CLIA NUMBER - HOOK-SUPERX, LLC DBA CVS/PHARMACY #06463

Laboratory Demographics

  • CLIA Code: 15D2283118
  • Facility Name: HOOK-SUPERX, LLC DBA CVS/PHARMACY #06463
  • Facility Address: 2210 E EDISON
    SOUTH BEND, IN
    ZIP 46615
  • Facility Phone: 574 472-3234
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AZZEDINE BENCHAAR
  • NPI Number: 1326141003
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2283118
LAB Type Pharmacy
Facility Name HOOK-SUPERX, LLC DBA CVS/PHARMACY #06463
Street 2210 E EDISON
City SOUTH BEND
State IN
ZIP 46615
Phone 574 472-3234
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 AZZEDINE BENCHAAR

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