14D2015236 CLIA NUMBER - WALGREENS # 05665

Laboratory Demographics

  • CLIA Code: 14D2015236
  • Facility Name: WALGREENS # 05665
  • Facility Address: 2 COTTONWOOD RD
    GLEN CARBON, IL
    ZIP 62034
  • Facility Phone: 618 288-4684
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARA ROOD
  • NPI Number: 1609881838
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015236
LAB Type Pharmacy
Facility Name WALGREENS # 05665
Street 2 COTTONWOOD RD
City GLEN CARBON
State IL
ZIP 62034
Phone 618 288-4684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director SARA ROOD

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