14D1032959 CLIA NUMBER - OSCO DRUG #2517

Laboratory Demographics

  • CLIA Code: 14D1032959
  • Facility Name: OSCO DRUG #2517
  • Facility Address: 6140 NORTHWEST HWY
    CRYSTAL LAKE, IL
    ZIP 60014
  • Facility Phone: 815 356-8592
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1083660476
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1032959
LAB Type Pharmacy
Facility Name OSCO DRUG #2517
Street 6140 NORTHWEST HWY
City CRYSTAL LAKE
State IL
ZIP 60014
Phone 815 356-8592
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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