14D1033292 CLIA NUMBER - OSCO DRUG #3073

Laboratory Demographics

  • CLIA Code: 14D1033292
  • Facility Name: OSCO DRUG #3073
  • Facility Address: 901 S COTTAGE AVE
    NORMAL, IL
    ZIP 61761
  • Facility Phone: 309 454-6080
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1487600151
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1033292
LAB Type Pharmacy
Facility Name OSCO DRUG #3073
Street 901 S COTTAGE AVE
City NORMAL
State IL
ZIP 61761
Phone 309 454-6080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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