14D1033175 CLIA NUMBER - OSCO DRUG #1074

Laboratory Demographics

  • CLIA Code: 14D1033175
  • Facility Name: OSCO DRUG #1074
  • Facility Address: 1403 W JEFFERSON ST
    JOLIET, IL
    ZIP 60435
  • Facility Phone: 815 725-1290
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1831145754
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1033175
LAB Type Pharmacy
Facility Name OSCO DRUG #1074
Street 1403 W JEFFERSON ST
City JOLIET
State IL
ZIP 60435
Phone 815 725-1290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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