14D2015242 CLIA NUMBER - WALGREENS #05927

Laboratory Demographics

  • CLIA Code: 14D2015242
  • Facility Name: WALGREENS #05927
  • Facility Address: 324 ROOSEVELT RD
    GLEN ELLYN, IL
    ZIP 60137
  • Facility Phone: 630 858-2930
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTIN JEFFREY
  • NPI Number: 1689681678
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015242
LAB Type Pharmacy
Facility Name WALGREENS #05927
Street 324 ROOSEVELT RD
City GLEN ELLYN
State IL
ZIP 60137
Phone 630 858-2930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Pharmacy
Lab Director MARTIN JEFFREY

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