14D2015121 CLIA NUMBER - WALGREENS # 03995

Laboratory Demographics

  • CLIA Code: 14D2015121
  • Facility Name: WALGREENS # 03995
  • Facility Address: 6 E NORTH AVE
    NORTHLAKE, IL
    ZIP 60164
  • Facility Phone: 708 836-0348
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SYED A. ANWAR
  • NPI Number: 1336154566
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015121
LAB Type Pharmacy
Facility Name WALGREENS # 03995
Street 6 E NORTH AVE
City NORTHLAKE
State IL
ZIP 60164
Phone 708 836-0348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Pharmacy
Lab Director SYED A. ANWAR

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