14D2015275 CLIA NUMBER - WALGREENS # 06980

Laboratory Demographics

  • CLIA Code: 14D2015275
  • Facility Name: WALGREENS # 06980
  • Facility Address: 3019 W PETERSON AVE
    CHICAGO, IL
    ZIP 60659
  • Facility Phone: 773 728-6254
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH PERA
  • NPI Number: 1437528528
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015275
LAB Type Pharmacy
Facility Name WALGREENS # 06980
Street 3019 W PETERSON AVE
City CHICAGO
State IL
ZIP 60659
Phone 773 728-6254
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director JOSEPH PERA

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