14D2014556 CLIA NUMBER - WALGREENS # 15164

Laboratory Demographics

  • CLIA Code: 14D2014556
  • Facility Name: WALGREENS # 15164
  • Facility Address: 2611 E OAKLAND AVE
    BLOOMINGTON, IL
    ZIP 61701
  • Facility Phone: 309 663-8344
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHAD M. GARNER
  • NPI Number: 1861407983
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2014556
LAB Type Pharmacy
Facility Name WALGREENS # 15164
Street 2611 E OAKLAND AVE
City BLOOMINGTON
State IL
ZIP 61701
Phone 309 663-8344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director CHAD M. GARNER

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