14D2030428 CLIA NUMBER - WALGREENS 06727

Laboratory Demographics

  • CLIA Code: 14D2030428
  • Facility Name: WALGREENS 06727
  • Facility Address: 4720 N MARINE DR
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: 773 769-1315
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADNAN A. EBRAHIM
  • NPI Number: 1003821315
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2030428
LAB Type Pharmacy
Facility Name WALGREENS 06727
Street 4720 N MARINE DR
City CHICAGO
State IL
ZIP 60640
Phone 773 769-1315
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Pharmacy
Lab Director ADNAN A. EBRAHIM

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