14D1093983 CLIA NUMBER - WALGREENS #09145

Laboratory Demographics

  • CLIA Code: 14D1093983
  • Facility Name: WALGREENS #09145
  • Facility Address: 1900 W JEFFERSON ST
    SPRINGFIELD, IL
    ZIP 62702
  • Facility Phone: 217 787-0648
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHAEL N. DWINNELLS
  • NPI Number: 1720093933
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1093983
LAB Type Pharmacy
Facility Name WALGREENS #09145
Street 1900 W JEFFERSON ST
City SPRINGFIELD
State IL
ZIP 62702
Phone 217 787-0648
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director RACHAEL N. DWINNELLS

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