14D2015281 CLIA NUMBER - WALGREENS #09000

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Laboratory Demographics

CLIA Number: 14D2015281

Facility Name: WALGREENS #09000

Facility Address:
2001 N MILWAUKEE AVE
CHICAGO, IL
ZIP 60647
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Facility Phone Number: 773 772-2370

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1366457574

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	14D2015281
LAB Type	Pharmacy
Facility Name	WALGREENS #09000
Street	2001 N MILWAUKEE AVE
City	CHICAGO
State	IL
ZIP	60647
Phone	773 772-2370
CertificateType	4
CertificateEffectiveDate	9/10/2023
CertificateExpirationDate	9/9/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024