14D1098112 CLIA NUMBER - WALGREENS #10718

Laboratory Demographics

  • CLIA Code: 14D1098112
  • Facility Name: WALGREENS #10718
  • Facility Address: 1202 W UNION AVE
    LITCHFIELD, IL
    ZIP 62056
  • Facility Phone: 217 324-7670
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CELIA CUSANELLI
  • NPI Number: 1548467996
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1098112
LAB Type Pharmacy
Facility Name WALGREENS #10718
Street 1202 W UNION AVE
City LITCHFIELD
State IL
ZIP 62056
Phone 217 324-7670
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 CELIA CUSANELLI

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