14D2015172 CLIA NUMBER - WALGREENS # 04636

Laboratory Demographics

  • CLIA Code: 14D2015172
  • Facility Name: WALGREENS # 04636
  • Facility Address: 1000 OGDEN AVE
    DOWNERS GROVE, IL
    ZIP 60515
  • Facility Phone: 630 493-1567
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADAM R. CONLIN
  • NPI Number: 1790790970
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015172
LAB Type Pharmacy
Facility Name WALGREENS # 04636
Street 1000 OGDEN AVE
City DOWNERS GROVE
State IL
ZIP 60515
Phone 630 493-1567
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director ADAM R. CONLIN

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