14D2027144 CLIA NUMBER - WALGREENS # 09920

Laboratory Demographics

  • CLIA Code: 14D2027144
  • Facility Name: WALGREENS # 09920
  • Facility Address: 555 N MAIN ST
    CANTON, IL
    ZIP 61520
  • Facility Phone: 309 647-7610
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN A. FREEMAN
  • NPI Number: 1497839633
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2027144
LAB Type Pharmacy
Facility Name WALGREENS # 09920
Street 555 N MAIN ST
City CANTON
State IL
ZIP 61520
Phone 309 647-7610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director JUSTIN A. FREEMAN

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