14D2015168 CLIA NUMBER - WALGREENS #04503

Laboratory Demographics

  • CLIA Code: 14D2015168
  • Facility Name: WALGREENS #04503
  • Facility Address: 9301 WAUKEGAN RD
    MORTON GROVE, IL
    ZIP 60053
  • Facility Phone: 847 965-2444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENISH S. GHEEWALA
  • NPI Number: 1609157296
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015168
LAB Type Pharmacy
Facility Name WALGREENS #04503
Street 9301 WAUKEGAN RD
City MORTON GROVE
State IL
ZIP 60053
Phone 847 965-2444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Pharmacy
Lab Director JENISH S. GHEEWALA

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