14D2034860 CLIA NUMBER - WALGREENS # 12787

Laboratory Demographics

  • CLIA Code: 14D2034860
  • Facility Name: WALGREENS # 12787
  • Facility Address: 400 W FAIRCHLD ST
    DANVILLE, IL
    ZIP 61832
  • Facility Phone: 217 442-7388
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK REEVES
  • NPI Number: 1881609022
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2034860
LAB Type Pharmacy
Facility Name WALGREENS # 12787
Street 400 W FAIRCHLD ST
City DANVILLE
State IL
ZIP 61832
Phone 217 442-7388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director MARK REEVES

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This page was last updated on: 6/4/2025