14D1032870 CLIA NUMBER - OSCO DRUG #0230

Laboratory Demographics

CLIA Number: 14D1032870

Facility Name: OSCO DRUG #0230

Facility Address:
7530 S STONY ISLAND AVE
CHICAGO, IL
ZIP 60649
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Facility Phone Number: 773 288-7002

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003862780

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	14D1032870
LAB Type	Pharmacy
Facility Name	OSCO DRUG #0230
Street	7530 S STONY ISLAND AVE
City	CHICAGO
State	IL
ZIP	60649
Phone	773 288-7002
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