14D2015128 CLIA NUMBER - WALGREENS # 04097

Laboratory Demographics

  • CLIA Code: 14D2015128
  • Facility Name: WALGREENS # 04097
  • Facility Address: 7501 GRAND AVE
    GURNEE, IL
    ZIP 60031
  • Facility Phone: 847 265-9641
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA PITON
  • NPI Number: 1164437331
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015128
LAB Type Pharmacy
Facility Name WALGREENS # 04097
Street 7501 GRAND AVE
City GURNEE
State IL
ZIP 60031
Phone 847 265-9641
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 CYNTHIA PITON

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