14D1033498 CLIA NUMBER - OSCO DRUG #3456

Laboratory Demographics

  • CLIA Code: 14D1033498
  • Facility Name: OSCO DRUG #3456
  • Facility Address: 411 GREEN BAY RD
    WILMETTE, IL
    ZIP 60091
  • Facility Phone: 847 853-8001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1902852684
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1033498
LAB Type Pharmacy
Facility Name OSCO DRUG #3456
Street 411 GREEN BAY RD
City WILMETTE
State IL
ZIP 60091
Phone 847 853-8001
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