14D2014537 CLIA NUMBER - WALGREENS 01496

Laboratory Demographics

  • CLIA Code: 14D2014537
  • Facility Name: WALGREENS 01496
  • Facility Address: 6310 N NAGLE AVE
    CHICAGO, IL
    ZIP 60646
  • Facility Phone: 773 774-2225
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAYLOR A. CLARK
  • NPI Number: 1073528295
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2014537
LAB Type Pharmacy
Facility Name WALGREENS 01496
Street 6310 N NAGLE AVE
City CHICAGO
State IL
ZIP 60646
Phone 773 774-2225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Pharmacy
Lab Director TAYLOR A. CLARK

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