14D2021341 CLIA NUMBER - WALGREENS #13004

Laboratory Demographics

  • CLIA Code: 14D2021341
  • Facility Name: WALGREENS #13004
  • Facility Address: 1600 W MAIN ST
    CARBONDALE, IL
    ZIP 62901
  • Facility Phone: 618 457-8397
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VALERIE J. HUBBARD
  • NPI Number: 1477867372
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2021341
LAB Type Pharmacy
Facility Name WALGREENS #13004
Street 1600 W MAIN ST
City CARBONDALE
State IL
ZIP 62901
Phone 618 457-8397
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Pharmacy
Lab Director VALERIE J. HUBBARD

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