14D1032861 CLIA NUMBER - OSCO DRUG #3407

Laboratory Demographics

  • CLIA Code: 14D1032861
  • Facility Name: OSCO DRUG #3407
  • Facility Address: 5532 N CLARK
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: 773 784-7348
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1992743132
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1032861
LAB Type Pharmacy
Facility Name OSCO DRUG #3407
Street 5532 N CLARK
City CHICAGO
State IL
ZIP 60640
Phone 773 784-7348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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