14D2035103 CLIA NUMBER - WALGREENS 15196

Laboratory Demographics

  • CLIA Code: 14D2035103
  • Facility Name: WALGREENS 15196
  • Facility Address: 151 N STATE ST - 1ST FLR
    CHICAGO, IL
    ZIP 60601
  • Facility Phone: 312 863-4249
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT J. SIMKO
  • NPI Number: 1710254131
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2035103
LAB Type Pharmacy
Facility Name WALGREENS 15196
Street 151 N STATE ST - 1ST FLR
City CHICAGO
State IL
ZIP 60601
Phone 312 863-4249
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Pharmacy
Lab Director ROBERT J. SIMKO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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