14D2015095 CLIA NUMBER - WALGREENS #03861

Laboratory Demographics

  • CLIA Code: 14D2015095
  • Facility Name: WALGREENS #03861
  • Facility Address: 612 RAYMOND DR
    NAPERVILLE, IL
    ZIP 60563
  • Facility Phone: 630 428-9171
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON LIM
  • NPI Number: 1073528246
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015095
LAB Type Pharmacy
Facility Name WALGREENS #03861
Street 612 RAYMOND DR
City NAPERVILLE
State IL
ZIP 60563
Phone 630 428-9171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Pharmacy
Lab Director JASON LIM

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