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14D1033492 CLIA NUMBER - OSCO DRUG #3515

Laboratory Demographics

CLIA Number: 14D1033492

Facility Name: OSCO DRUG #3515

Facility Address:
543 W LIBERTY ST
WAUCONDA, IL
ZIP 60084
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Facility Phone Number: 847 526-1239

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043267594

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 14D1033492
LAB Type Pharmacy
Facility Name OSCO DRUG #3515
Street 543 W LIBERTY ST
City WAUCONDA
State IL
ZIP 60084
Phone 847 526-1239
CertificateType 4
CertificateEffectiveDate 11/9/2022
CertificateExpirationDate 11/8/2024
FacilityType Waiver

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