14D2015122 CLIA NUMBER - WALGREENS #04024

Laboratory Demographics

  • CLIA Code: 14D2015122
  • Facility Name: WALGREENS #04024
  • Facility Address: 5890 N BELT W
    BELLEVILLE, IL
    ZIP 62226
  • Facility Phone: 618 277-4440
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN J. HART
  • NPI Number: 1487669784
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015122
LAB Type Pharmacy
Facility Name WALGREENS #04024
Street 5890 N BELT W
City BELLEVILLE
State IL
ZIP 62226
Phone 618 277-4440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director BRIAN J. HART

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