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14D2015088 CLIA NUMBER - WALGREENS 03710

Laboratory Demographics

CLIA Number: 14D2015088

Facility Name: WALGREENS 03710

Facility Address:
15575 E 127TH ST
LEMONT, IL
ZIP 60439
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Facility Phone Number: 630 257-9250

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1720093040

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 14D2015088
LAB Type Pharmacy
Facility Name WALGREENS 03710
Street 15575 E 127TH ST
City LEMONT
State IL
ZIP 60439
Phone 630 257-9250
CertificateType 4
CertificateEffectiveDate 10/5/2023
CertificateExpirationDate 10/4/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024