14D2015285 CLIA NUMBER - WALGREENS #09709

Laboratory Demographics

  • CLIA Code: 14D2015285
  • Facility Name: WALGREENS #09709
  • Facility Address: 4010 W LAWRENCE AVE
    CHICAGO, IL
    ZIP 60630
  • Facility Phone: 773 286-0309
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DINGCHEN SHA
  • NPI Number: 1710992037
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2015285
LAB Type Pharmacy
Facility Name WALGREENS #09709
Street 4010 W LAWRENCE AVE
City CHICAGO
State IL
ZIP 60630
Phone 773 286-0309
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Pharmacy
Lab Director DINGCHEN SHA

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