14D1032730 CLIA NUMBER - OSCO DRUG #0116

Laboratory Demographics

  • CLIA Code: 14D1032730
  • Facility Name: OSCO DRUG #0116
  • Facility Address: 2201 E OAKLAND AVE
    BLOOMINGTON, IL
    ZIP 61701
  • Facility Phone: 309 663-6341
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1194771865
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1032730
LAB Type Pharmacy
Facility Name OSCO DRUG #0116
Street 2201 E OAKLAND AVE
City BLOOMINGTON
State IL
ZIP 61701
Phone 309 663-6341
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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