14D2015100 CLIA NUMBER - WALGREENS 03929

Laboratory Demographics

  • CLIA Code: 14D2015100
  • Facility Name: WALGREENS 03929
  • Facility Address: 1801 INGALLS AVE
    JOLIET, IL
    ZIP 60435
  • Facility Phone: 815 729-1680
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANNA I. SAMARA
  • NPI Number: 1285820605
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015100
LAB Type Pharmacy
Facility Name WALGREENS 03929
Street 1801 INGALLS AVE
City JOLIET
State IL
ZIP 60435
Phone 815 729-1680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Pharmacy
Lab Director DANNA I. SAMARA

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