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14D1032862 CLIA NUMBER - OSCO DRUG #3443

Laboratory Demographics

CLIA Number: 14D1032862

Facility Name: OSCO DRUG #3443

Facility Address:
5354 N BROADWAY ST
CHICAGO, IL
ZIP 60640
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Facility Phone Number: 773 334-2083

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1699721308

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 14D1032862
LAB Type Pharmacy
Facility Name OSCO DRUG #3443
Street 5354 N BROADWAY ST
City CHICAGO
State IL
ZIP 60640
Phone 773 334-2083
CertificateType 4
CertificateEffectiveDate 10/29/2022
CertificateExpirationDate 10/28/2024
FacilityType Waiver

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