14D2015052 CLIA NUMBER - WALGREENS # 03273

Laboratory Demographics

  • CLIA Code: 14D2015052
  • Facility Name: WALGREENS # 03273
  • Facility Address: 655 ELM PL
    HIGHLAND PARK, IL
    ZIP 60035
  • Facility Phone: 847 266-8520
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GERVASIS MANUEL
  • NPI Number: 1427063684
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015052
LAB Type Pharmacy
Facility Name WALGREENS # 03273
Street 655 ELM PL
City HIGHLAND PARK
State IL
ZIP 60035
Phone 847 266-8520
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 GERVASIS MANUEL

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