14D2015246 CLIA NUMBER - WALGREENS #06003

Laboratory Demographics

  • CLIA Code: 14D2015246
  • Facility Name: WALGREENS #06003
  • Facility Address: 3336 11TH ST
    ROCKFORD, IL
    ZIP 61109
  • Facility Phone: 815 394-0357
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MADELINE CARLSON
  • NPI Number: 1891700084
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015246
LAB Type Pharmacy
Facility Name WALGREENS #06003
Street 3336 11TH ST
City ROCKFORD
State IL
ZIP 61109
Phone 815 394-0357
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Pharmacy
Lab Director MADELINE CARLSON

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