14D1033227 CLIA NUMBER - OSCO DRUG #3084

Laboratory Demographics

  • CLIA Code: 14D1033227
  • Facility Name: OSCO DRUG #3084
  • Facility Address: 199 BROOK FOREST AVE
    SHOREWOOD, IL
    ZIP 60431
  • Facility Phone: 815 730-3973
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1982650370
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1033227
LAB Type Pharmacy
Facility Name OSCO DRUG #3084
Street 199 BROOK FOREST AVE
City SHOREWOOD
State IL
ZIP 60431
Phone 815 730-3973
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