14D2015248 CLIA NUMBER - WALGREENS # 06079

Laboratory Demographics

  • CLIA Code: 14D2015248
  • Facility Name: WALGREENS # 06079
  • Facility Address: 4814 N SHERIDAN RD
    PEORIA, IL
    ZIP 61614
  • Facility Phone: 309 688-6752
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES L. LAZZARI
  • NPI Number: 1275548463
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015248
LAB Type Pharmacy
Facility Name WALGREENS # 06079
Street 4814 N SHERIDAN RD
City PEORIA
State IL
ZIP 61614
Phone 309 688-6752
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Pharmacy
Lab Director JAMES L. LAZZARI

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