14D2020193 CLIA NUMBER - WALGREENS #01101

Laboratory Demographics

  • CLIA Code: 14D2020193
  • Facility Name: WALGREENS #01101
  • Facility Address: 1533 E 67TH ST
    CHICAGO, IL
    ZIP 60637
  • Facility Phone: 773 493-0733
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HAKEEM IDRIS
  • NPI Number: 1659393189
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2020193
LAB Type Pharmacy
Facility Name WALGREENS #01101
Street 1533 E 67TH ST
City CHICAGO
State IL
ZIP 60637
Phone 773 493-0733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type Pharmacy
Lab Director HAKEEM IDRIS

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