14D2015268 CLIA NUMBER - WALGREENS # 06746

Laboratory Demographics

  • CLIA Code: 14D2015268
  • Facility Name: WALGREENS # 06746
  • Facility Address: 151 NORTHWEST HWY
    CRYSTAL LAKE, IL
    ZIP 60014
  • Facility Phone: 815 455-2460
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY P. DIETZ
  • NPI Number: 1205841509
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015268
LAB Type Pharmacy
Facility Name WALGREENS # 06746
Street 151 NORTHWEST HWY
City CRYSTAL LAKE
State IL
ZIP 60014
Phone 815 455-2460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director BRADLEY P. DIETZ

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