14D2015170 CLIA NUMBER - WALGREENS # 04542

Laboratory Demographics

  • CLIA Code: 14D2015170
  • Facility Name: WALGREENS # 04542
  • Facility Address: 5625 N RIDGE AVE
    CHICAGO, IL
    ZIP 60660
  • Facility Phone: 773 989-7546
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NASHEET QUARAISHI
  • NPI Number: 1710992995
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015170
LAB Type Pharmacy
Facility Name WALGREENS # 04542
Street 5625 N RIDGE AVE
City CHICAGO
State IL
ZIP 60660
Phone 773 989-7546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Pharmacy
Lab Director NASHEET QUARAISHI

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