14D2021899 CLIA NUMBER - WALGREENS # 03961

Laboratory Demographics

  • CLIA Code: 14D2021899
  • Facility Name: WALGREENS # 03961
  • Facility Address: 2340 W MADISON ST
    CHICAGO, IL
    ZIP 60612
  • Facility Phone: 312 226-7913
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TOMINIQUE L. JOHNSON
  • NPI Number: 1285649475
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2021899
LAB Type Pharmacy
Facility Name WALGREENS # 03961
Street 2340 W MADISON ST
City CHICAGO
State IL
ZIP 60612
Phone 312 226-7913
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Pharmacy
Lab Director TOMINIQUE L. JOHNSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025