14D2014808 CLIA NUMBER - WALGREENS #15249

Laboratory Demographics

  • CLIA Code: 14D2014808
  • Facility Name: WALGREENS #15249
  • Facility Address: 1723 BROADWAY ST
    QUINCY, IL
    ZIP 62301
  • Facility Phone: 217 222-0792
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS MALINOWSKI
  • NPI Number: 1811902950
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2014808
LAB Type Pharmacy
Facility Name WALGREENS #15249
Street 1723 BROADWAY ST
City QUINCY
State IL
ZIP 62301
Phone 217 222-0792
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director NICHOLAS MALINOWSKI

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