14D2015123 CLIA NUMBER - WALGREENS # 04032

Laboratory Demographics

  • CLIA Code: 14D2015123
  • Facility Name: WALGREENS # 04032
  • Facility Address: 466 NELSON RD
    NEW LENOX, IL
    ZIP 60451
  • Facility Phone: 815 485-2735
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDER PAK
  • NPI Number: 1992710214
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015123
LAB Type Pharmacy
Facility Name WALGREENS # 04032
Street 466 NELSON RD
City NEW LENOX
State IL
ZIP 60451
Phone 815 485-2735
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director ALEXANDER PAK

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