14D2023572 CLIA NUMBER - WALGREENS 07630

Laboratory Demographics

  • CLIA Code: 14D2023572
  • Facility Name: WALGREENS 07630
  • Facility Address: 933 N STATE ST
    CHICAGO, IL
    ZIP 60610
  • Facility Phone: 312 943-0671
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NILA GORJI
  • NPI Number: 1538176516
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2023572
LAB Type Pharmacy
Facility Name WALGREENS 07630
Street 933 N STATE ST
City CHICAGO
State IL
ZIP 60610
Phone 312 943-0671
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Pharmacy
Lab Director NILA GORJI

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