14D2015130 CLIA NUMBER - WALGREENS # 04142

Laboratory Demographics

  • CLIA Code: 14D2015130
  • Facility Name: WALGREENS # 04142
  • Facility Address: 1050 N KENNEDY DR
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 815 932-9615
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK J. MURRAY
  • NPI Number: 1598772592
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015130
LAB Type Pharmacy
Facility Name WALGREENS # 04142
Street 1050 N KENNEDY DR
City KANKAKEE
State IL
ZIP 60901
Phone 815 932-9615
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 MARK J. MURRAY

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