14D1034228 CLIA NUMBER - OSCO DRUG #2363

Laboratory Demographics

  • CLIA Code: 14D1034228
  • Facility Name: OSCO DRUG #2363
  • Facility Address: 5610 159TH ST
    OAK FOREST, IL
    ZIP 60452
  • Facility Phone: 708 687-0122
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1821044504
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1034228
LAB Type Pharmacy
Facility Name OSCO DRUG #2363
Street 5610 159TH ST
City OAK FOREST
State IL
ZIP 60452
Phone 708 687-0122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2024
Certificate Expiration Date 11/28/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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