14D2015192 CLIA NUMBER - WALGREENS #04948

Laboratory Demographics

  • CLIA Code: 14D2015192
  • Facility Name: WALGREENS #04948
  • Facility Address: 101 LILY CACHE LN
    BOLINGBROOK, IL
    ZIP 60440
  • Facility Phone: 630 759-3011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HARDIK S. PATEL
  • NPI Number: 1952453383
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015192
LAB Type Pharmacy
Facility Name WALGREENS #04948
Street 101 LILY CACHE LN
City BOLINGBROOK
State IL
ZIP 60440
Phone 630 759-3011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director HARDIK S. PATEL

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