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14D1032959 CLIA NUMBER - OSCO DRUG #2517

Laboratory Demographics

CLIA Number: 14D1032959

Facility Name: OSCO DRUG #2517

Facility Address:
6140 NORTHWEST HWY
CRYSTAL LAKE, IL
ZIP 60014
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Facility Phone Number: 815 356-8592

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1083660476

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 14D1032959
LAB Type Pharmacy
Facility Name OSCO DRUG #2517
Street 6140 NORTHWEST HWY
City CRYSTAL LAKE
State IL
ZIP 60014
Phone 815 356-8592
CertificateType 4
CertificateEffectiveDate 11/1/2022
CertificateExpirationDate 10/31/2024
FacilityType Waiver

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