14D2015152 CLIA NUMBER - WALGREENS # 04150

Laboratory Demographics

  • CLIA Code: 14D2015152
  • Facility Name: WALGREENS # 04150
  • Facility Address: 230 W CHRYSLER DR
    BELVIDERE, IL
    ZIP 61008
  • Facility Phone: 815 544-4790
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN S. CHOE
  • NPI Number: 1184051138
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2015152
LAB Type Pharmacy
Facility Name WALGREENS # 04150
Street 230 W CHRYSLER DR
City BELVIDERE
State IL
ZIP 61008
Phone 815 544-4790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Pharmacy
Lab Director BRIAN S. CHOE

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