14D2015217 CLIA NUMBER - WALGREENS #05234 WALGREENS

Laboratory Demographics

  • CLIA Code: 14D2015217
  • Facility Name: WALGREENS #05234 WALGREENS
  • Facility Address: 5435 S KEDZIE AVE
    CHICAGO, IL
    ZIP 60632
  • Facility Phone: 773 436-7396
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UYEN N. PHAN
  • NPI Number: 1144502212
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015217
LAB Type Pharmacy
Facility Name WALGREENS #05234 WALGREENS
Street 5435 S KEDZIE AVE
City CHICAGO
State IL
ZIP 60632
Phone 773 436-7396
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Pharmacy
Lab Director UYEN N. PHAN

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