14D1002612 CLIA NUMBER - OSCO DRUG #4047

Laboratory Demographics

  • CLIA Code: 14D1002612
  • Facility Name: OSCO DRUG #4047
  • Facility Address: 6215 MAIN ST
    DOWNERS GROVE, IL
    ZIP 60515
  • Facility Phone: 630 971-0220
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1962458497
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1002612
LAB Type Pharmacy
Facility Name OSCO DRUG #4047
Street 6215 MAIN ST
City DOWNERS GROVE
State IL
ZIP 60515
Phone 630 971-0220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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