14D2013993 CLIA NUMBER - WALGREENS #04504

Laboratory Demographics

  • CLIA Code: 14D2013993
  • Facility Name: WALGREENS #04504
  • Facility Address: 844 W FREMONT ST
    GALESBURG, IL
    ZIP 61401
  • Facility Phone: 309 343-5141
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATALIE J. JOHNSON
  • NPI Number: 1457366650
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2013993
LAB Type Pharmacy
Facility Name WALGREENS #04504
Street 844 W FREMONT ST
City GALESBURG
State IL
ZIP 61401
Phone 309 343-5141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director NATALIE J. JOHNSON

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