14D1091368 CLIA NUMBER - WALGREENS #10800

Laboratory Demographics

  • CLIA Code: 14D1091368
  • Facility Name: WALGREENS #10800
  • Facility Address: 424 W VAN BUREN ST
    CLINTON, IL
    ZIP 61727
  • Facility Phone: 217 935-1357
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMBER L. SIMMONS
  • NPI Number: 1164624870
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1091368
LAB Type Pharmacy
Facility Name WALGREENS #10800
Street 424 W VAN BUREN ST
City CLINTON
State IL
ZIP 61727
Phone 217 935-1357
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director AMBER L. SIMMONS

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