14D2014487 CLIA NUMBER - WALGREENS 00162

Laboratory Demographics

  • CLIA Code: 14D2014487
  • Facility Name: WALGREENS 00162
  • Facility Address: 1554 E 55TH ST
    CHICAGO, IL
    ZIP 60615
  • Facility Phone: 773 667-1177
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRYSTAL A. EARLE
  • NPI Number: 1316952443
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2014487
LAB Type Pharmacy
Facility Name WALGREENS 00162
Street 1554 E 55TH ST
City CHICAGO
State IL
ZIP 60615
Phone 773 667-1177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Pharmacy
Lab Director KRYSTAL A. EARLE

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