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14D2016706 CLIA NUMBER - WALGREENS #03076

Laboratory Demographics

CLIA Number: 14D2016706

Facility Name: WALGREENS #03076

Facility Address:
7251 LAKE ST
RIVER FOREST, IL
ZIP 60305
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Facility Phone Number: 708 366-9960

Facility Type: Other - COVID 19 TEST SITE

Certificate Type: Waiver
NPI Number: 1053326181

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 14D2016706
LAB Type Other - COVID 19 TEST SITE
Facility Name WALGREENS #03076
Street 7251 LAKE ST
City RIVER FOREST
State IL
ZIP 60305
Phone 708 366-9960
CertificateType 4
CertificateEffectiveDate 12/23/2022
CertificateExpirationDate 12/22/2024
FacilityType Waiver

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