14D2015245 CLIA NUMBER - WALGREENS # 06001

Laboratory Demographics

  • CLIA Code: 14D2015245
  • Facility Name: WALGREENS # 06001
  • Facility Address: 5065 HONONEGAH RD
    ROSCOE, IL
    ZIP 61073
  • Facility Phone: 815 623-5079
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVEN E. KOEPSELL
  • NPI Number: 1265447452
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015245
LAB Type Pharmacy
Facility Name WALGREENS # 06001
Street 5065 HONONEGAH RD
City ROSCOE
State IL
ZIP 61073
Phone 815 623-5079
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2025
Certificate Expiration Date 2/18/2027
Facility Type Pharmacy
Lab Director STEVEN E. KOEPSELL

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