14D1050512 CLIA NUMBER - OSCO DRUG #3730

Laboratory Demographics

  • CLIA Code: 14D1050512
  • Facility Name: OSCO DRUG #3730
  • Facility Address: 2051 RIDGE RD
    MINOOKA, IL
    ZIP 60447
  • Facility Phone: 815 467-1254
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1811944366
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1050512
LAB Type Pharmacy
Facility Name OSCO DRUG #3730
Street 2051 RIDGE RD
City MINOOKA
State IL
ZIP 60447
Phone 815 467-1254
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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