15D2283676 CLIA NUMBER - HOOK-SUPERX LLC DBA CVS/PHARMACY #06677

Laboratory Demographics

  • CLIA Code: 15D2283676
  • Facility Name: HOOK-SUPERX LLC DBA CVS/PHARMACY #06677
  • Facility Address: 3630 S 18TH ST
    LAFAYETTE, IN
    ZIP 47909
  • Facility Phone: 765 474-3834
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IRFAN SALAM
  • NPI Number: 1285737791
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2283676
LAB Type Pharmacy
Facility Name HOOK-SUPERX LLC DBA CVS/PHARMACY #06677
Street 3630 S 18TH ST
City LAFAYETTE
State IN
ZIP 47909
Phone 765 474-3834
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Pharmacy
Lab Director IRFAN SALAM

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This page was last updated on: 6/4/2025