14D2027121 CLIA NUMBER - WALGREENS 00147

Laboratory Demographics

  • CLIA Code: 14D2027121
  • Facility Name: WALGREENS 00147
  • Facility Address: 3611 E 106TH ST
    CHICAGO, IL
    ZIP 60617
  • Facility Phone: 773 978-1988
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LYNN M. PUTOREK-MARLOWE
  • NPI Number: 1730196767
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2027121
LAB Type Pharmacy
Facility Name WALGREENS 00147
Street 3611 E 106TH ST
City CHICAGO
State IL
ZIP 60617
Phone 773 978-1988
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 LYNN M. PUTOREK-MARLOWE

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