14D2014553 CLIA NUMBER - WALGREENS # 02490

Laboratory Demographics

  • CLIA Code: 14D2014553
  • Facility Name: WALGREENS # 02490
  • Facility Address: 401 BELT LINE RD
    COLLINSVILLE, IL
    ZIP 62234
  • Facility Phone: 618 344-6639
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ZACH MADEJ
  • NPI Number: 1154336311
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2014553
LAB Type Pharmacy
Facility Name WALGREENS # 02490
Street 401 BELT LINE RD
City COLLINSVILLE
State IL
ZIP 62234
Phone 618 344-6639
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director ZACH MADEJ

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