14D1033475 CLIA NUMBER - OSCO DRUG #4516

Laboratory Demographics

  • CLIA Code: 14D1033475
  • Facility Name: OSCO DRUG #4516
  • Facility Address: 920 N GREEN BAY RD
    WAUKEGAN, IL
    ZIP 60085
  • Facility Phone: 847 623-7066
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1477591782
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1033475
LAB Type Pharmacy
Facility Name OSCO DRUG #4516
Street 920 N GREEN BAY RD
City WAUKEGAN
State IL
ZIP 60085
Phone 847 623-7066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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