14D2015174 CLIA NUMBER - WALGREENS # 04732

Laboratory Demographics

  • CLIA Code: 14D2015174
  • Facility Name: WALGREENS # 04732
  • Facility Address: 2020 COURT ST
    PEKIN, IL
    ZIP 61554
  • Facility Phone: 309 347-5589
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. HAENSEL
  • NPI Number: 1376550301
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015174
LAB Type Pharmacy
Facility Name WALGREENS # 04732
Street 2020 COURT ST
City PEKIN
State IL
ZIP 61554
Phone 309 347-5589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director MICHAEL D. HAENSEL

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