14D2014535 CLIA NUMBER - WALGREENS # 01450

Laboratory Demographics

  • CLIA Code: 14D2014535
  • Facility Name: WALGREENS # 01450
  • Facility Address: 4101 1ST AVE
    LYONS, IL
    ZIP 60534
  • Facility Phone: 708 447-6851
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CARYL L. SIZEMORE
  • NPI Number: 1790790913
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2014535
LAB Type Pharmacy
Facility Name WALGREENS # 01450
Street 4101 1ST AVE
City LYONS
State IL
ZIP 60534
Phone 708 447-6851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Pharmacy
Lab Director CARYL L. SIZEMORE

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This page was last updated on: 6/4/2025