14D1033308 CLIA NUMBER - OSCO DRUG #2160

Laboratory Demographics

CLIA Number: 14D1033308

Facility Name: OSCO DRUG #2160

Facility Address:
9650 W 131ST STREET
PALOS PARK, IL
ZIP 60464
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Facility Phone Number: 708 361-8090

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1235179417

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	14D1033308
LAB Type	Pharmacy
Facility Name	OSCO DRUG #2160
Street	9650 W 131ST STREET
City	PALOS PARK
State	IL
ZIP	60464
Phone	708 361-8090
CertificateType	4
CertificateEffectiveDate	11/8/2022
CertificateExpirationDate	11/7/2024
FacilityType	Waiver

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