14D1094717 CLIA NUMBER - WALGREENS #02071

Laboratory Demographics

  • CLIA Code: 14D1094717
  • Facility Name: WALGREENS #02071
  • Facility Address: 2020 S MACARTHUR BLVD
    SPRINGFIELD, IL
    ZIP 62704
  • Facility Phone: (217) 744-1880
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIANE HAGEMANN
  • NPI Number: 1346988326
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D1094717
LAB Type Pharmacy
Facility Name WALGREENS #02071
Street 2020 S MACARTHUR BLVD
City SPRINGFIELD
State IL
ZIP 62704
Phone 2177441880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director DIANE HAGEMANN

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This page was last updated on: 5/18/2026