14D2015244 CLIA NUMBER - WALGREENS 05962

Laboratory Demographics

  • CLIA Code: 14D2015244
  • Facility Name: WALGREENS 05962
  • Facility Address: 4820 N CUMBERLAND AVE
    NORRIDGE, IL
    ZIP 60706
  • Facility Phone: 708 583-2133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HUSAMULDEEN M. DHARI
  • NPI Number: 1891433215
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2015244
LAB Type Pharmacy
Facility Name WALGREENS 05962
Street 4820 N CUMBERLAND AVE
City NORRIDGE
State IL
ZIP 60706
Phone 708 583-2133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Pharmacy
Lab Director HUSAMULDEEN M. DHARI

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