14D2015238 CLIA NUMBER - WALGREENS #05713

Laboratory Demographics

  • CLIA Code: 14D2015238
  • Facility Name: WALGREENS #05713
  • Facility Address: 4740 W 95TH ST
    OAK LAWN, IL
    ZIP 60453
  • Facility Phone: 708 425-6960
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIYAN K. STOYKOV
  • NPI Number: 1982610457
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015238
LAB Type Pharmacy
Facility Name WALGREENS #05713
Street 4740 W 95TH ST
City OAK LAWN
State IL
ZIP 60453
Phone 708 425-6960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Pharmacy
Lab Director MARIYAN K. STOYKOV

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