14D2015223 CLIA NUMBER - WALGREENS # 05444

Laboratory Demographics

  • CLIA Code: 14D2015223
  • Facility Name: WALGREENS # 05444
  • Facility Address: 212 S LOGAN AVE
    MATTOON, IL
    ZIP 61938
  • Facility Phone: 217 235-3126
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARAH A. CHISLER
  • NPI Number: 1629083761
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015223
LAB Type Pharmacy
Facility Name WALGREENS # 05444
Street 212 S LOGAN AVE
City MATTOON
State IL
ZIP 61938
Phone 217 235-3126
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director SARAH A. CHISLER

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