14D2015167 CLIA NUMBER - WALGREENS # 04464

Laboratory Demographics

  • CLIA Code: 14D2015167
  • Facility Name: WALGREENS # 04464
  • Facility Address: 910 N RAND RD
    LAKE ZURICH, IL
    ZIP 60047
  • Facility Phone: 847 550-9475
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL NARDEEN
  • NPI Number: 1083620587
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015167
LAB Type Pharmacy
Facility Name WALGREENS # 04464
Street 910 N RAND RD
City LAKE ZURICH
State IL
ZIP 60047
Phone 847 550-9475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Pharmacy
Lab Director MICHAEL NARDEEN

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