14D2015187 CLIA NUMBER - WALGREENS #04862

Laboratory Demographics

  • CLIA Code: 14D2015187
  • Facility Name: WALGREENS #04862
  • Facility Address: 4343 N CENTRAL AVE
    CHICAGO, IL
    ZIP 60634
  • Facility Phone: 773 427-9456
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH DEFRANK
  • NPI Number: 1750398731
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015187
LAB Type Pharmacy
Facility Name WALGREENS #04862
Street 4343 N CENTRAL AVE
City CHICAGO
State IL
ZIP 60634
Phone 773 427-9456
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Pharmacy
Lab Director JOSEPH DEFRANK

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