14D1033312 CLIA NUMBER - OSCO DRUG #1190

Laboratory Demographics

  • CLIA Code: 14D1033312
  • Facility Name: OSCO DRUG #1190
  • Facility Address: 13460 S ROUTE 59
    PLAINFIELD, IL
    ZIP 60585
  • Facility Phone: 815 577-2613
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1629024302
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1033312
LAB Type Pharmacy
Facility Name OSCO DRUG #1190
Street 13460 S ROUTE 59
City PLAINFIELD
State IL
ZIP 60585
Phone 815 577-2613
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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