14D2011164 CLIA NUMBER - OSCO DRUG # 3376

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Laboratory Demographics

CLIA Number: 14D2011164

Facility Name: OSCO DRUG # 3376

Facility Address:
370 N DES PLAINES ST
CHICAGO, IL
ZIP 60661
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Facility Phone Number: 312 243-2714

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1669636601

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	14D2011164
LAB Type	Pharmacy
Facility Name	OSCO DRUG # 3376
Street	370 N DES PLAINES ST
City	CHICAGO
State	IL
ZIP	60661
Phone	312 243-2714
CertificateType	4
CertificateEffectiveDate	8/12/2022
CertificateExpirationDate	8/11/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024