14D2015093 CLIA NUMBER - WALGREENS #03774

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Laboratory Demographics

CLIA Number: 14D2015093

Facility Name: WALGREENS #03774

Facility Address:
1207 N RANDALL RD
AURORA, IL
ZIP 60506
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Facility Phone Number: 630 897-7112

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1417962671

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	14D2015093
LAB Type	Pharmacy
Facility Name	WALGREENS #03774
Street	1207 N RANDALL RD
City	AURORA
State	IL
ZIP	60506
Phone	630 897-7112
CertificateType	4
CertificateEffectiveDate	9/2/2023
CertificateExpirationDate	9/1/2025
FacilityType	Waiver

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