14D2015208 CLIA NUMBER - WALGREENS #05126

Laboratory Demographics

  • CLIA Code: 14D2015208
  • Facility Name: WALGREENS #05126
  • Facility Address: 3564 RIDGE RD
    LANSING, IL
    ZIP 60438
  • Facility Phone: 708 895-7937
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA J. HARRIS
  • NPI Number: 1184639304
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015208
LAB Type Pharmacy
Facility Name WALGREENS #05126
Street 3564 RIDGE RD
City LANSING
State IL
ZIP 60438
Phone 708 895-7937
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Pharmacy
Lab Director AMANDA J. HARRIS

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