14D1034253 CLIA NUMBER - OSCO DRUG #1241

Laboratory Demographics

  • CLIA Code: 14D1034253
  • Facility Name: OSCO DRUG #1241
  • Facility Address: 1343 N PAULINA ST
    CHICAGO, IL
    ZIP 60622
  • Facility Phone: 773 342-5217
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1659327203
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1034253
LAB Type Pharmacy
Facility Name OSCO DRUG #1241
Street 1343 N PAULINA ST
City CHICAGO
State IL
ZIP 60622
Phone 773 342-5217
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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