14D1093089 CLIA NUMBER - WALGREENS #01770

Laboratory Demographics

  • CLIA Code: 14D1093089
  • Facility Name: WALGREENS #01770
  • Facility Address: 2625 STEVENSON DR
    SPRINGFIELD, IL
    ZIP 62703
  • Facility Phone: 217 529-8185
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE A. REAGON
  • NPI Number: 1558376764
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1093089
LAB Type Pharmacy
Facility Name WALGREENS #01770
Street 2625 STEVENSON DR
City SPRINGFIELD
State IL
ZIP 62703
Phone 217 529-8185
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Pharmacy
Lab Director MICHELLE A. REAGON

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