14D1062535 CLIA NUMBER - OSCO DRUG #1156

Laboratory Demographics

CLIA Number: 14D1062535

Facility Name: OSCO DRUG #1156

Facility Address:
446 S WASHINGTON AVE
KANKAKEE, IL
ZIP 60901
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Facility Phone Number: 815 935-2041

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1083776959

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	14D1062535
LAB Type	Pharmacy
Facility Name	OSCO DRUG #1156
Street	446 S WASHINGTON AVE
City	KANKAKEE
State	IL
ZIP	60901
Phone	815 935-2041
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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