15D2284058 CLIA NUMBER - HOOK- SUPERX LLC DBA CVS/PHARMACY #06707

Laboratory Demographics

  • CLIA Code: 15D2284058
  • Facility Name: HOOK- SUPERX LLC DBA CVS/PHARMACY #06707
  • Facility Address: 15622 NORTH STATE RD 79 /P O BOX 207
    EDINBURGH, IN
    ZIP 46124
  • Facility Phone: 812 526-2487
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROGER ATA
  • NPI Number: 1316040009
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2284058
LAB Type Pharmacy
Facility Name HOOK- SUPERX LLC DBA CVS/PHARMACY #06707
Street 15622 NORTH STATE RD 79 /P O BOX 207
City EDINBURGH
State IN
ZIP 46124
Phone 812 526-2487
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2025
Certificate Expiration Date 6/15/2027
Facility Type Pharmacy
Lab Director ROGER ATA

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