14D2015172 CLIA NUMBER - WALGREENS # 04636

Home > CLIA Lookup > 14D2015172

Laboratory Demographics

CLIA Number: 14D2015172

Facility Name: WALGREENS # 04636

Facility Address:
1000 OGDEN AVE
DOWNERS GROVE, IL
ZIP 60515
Get Directions

Facility Phone Number: 630 493-1567

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790790970

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType	4
CertificateEffectiveDate	6/17/2023
CertificateExpirationDate	6/16/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024