14D2015153 CLIA NUMBER - WALGREENS #04154

Laboratory Demographics

  • CLIA Code: 14D2015153
  • Facility Name: WALGREENS #04154
  • Facility Address: 20002 WOLF RD
    MOKENA, IL
    ZIP 60448
  • Facility Phone: 708 478-3244
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELANIE W. COHEN
  • NPI Number: 1811902000
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015153
LAB Type Pharmacy
Facility Name WALGREENS #04154
Street 20002 WOLF RD
City MOKENA
State IL
ZIP 60448
Phone 708 478-3244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Pharmacy
Lab Director MELANIE W. COHEN

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This page was last updated on: 6/4/2025