14D2015160 CLIA NUMBER - WALGREENS #04407

Laboratory Demographics

  • CLIA Code: 14D2015160
  • Facility Name: WALGREENS #04407
  • Facility Address: 3732 NAMEOKI RD
    GRANITE CITY, IL
    ZIP 62040
  • Facility Phone: 618 877-6880
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TERRI A. BRIGHT
  • NPI Number: 1215942511
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015160
LAB Type Pharmacy
Facility Name WALGREENS #04407
Street 3732 NAMEOKI RD
City GRANITE CITY
State IL
ZIP 62040
Phone 618 877-6880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2025
Certificate Expiration Date 10/21/2027
Facility Type Pharmacy
Lab Director TERRI A. BRIGHT

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