15D2291207 CLIA NUMBER - HOOK-SUPERX, LLC DBA CVS/PHARMACY #10983

Laboratory Demographics

CLIA Number: 15D2291207

Facility Name: HOOK-SUPERX, LLC DBA CVS/PHARMACY #10983

Facility Address:
1447 SOUTH WATERLEAF DR
WESTFIELD, IN
ZIP 46074
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Facility Phone Number: 317 816-1446

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1851805774

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	15D2291207
LAB Type	Pharmacy
Facility Name	HOOK-SUPERX, LLC DBA CVS/PHARMACY #10983
Street	1447 SOUTH WATERLEAF DR
City	WESTFIELD
State	IN
ZIP	46074
Phone	317 816-1446
CertificateType	4
CertificateEffectiveDate	10/6/2023
CertificateExpirationDate	10/5/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024