14D1033226 CLIA NUMBER - OSCO DRUG #1403

Laboratory Demographics

CLIA Number: 14D1033226

Facility Name: OSCO DRUG #1403

Facility Address:
7122 W 40TH ST
STICKNEY, IL
ZIP 60402
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Facility Phone Number: 708 484-8410

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1861448391

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	14D1033226
LAB Type	Pharmacy
Facility Name	OSCO DRUG #1403
Street	7122 W 40TH ST
City	STICKNEY
State	IL
ZIP	60402
Phone	708 484-8410
CertificateType	4
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Waiver

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