14D2036069 CLIA NUMBER - MARIANO'S PHARMACY #8529

Laboratory Demographics

  • CLIA Code: 14D2036069
  • Facility Name: MARIANO'S PHARMACY #8529
  • Facility Address: 14 GARDEN MARKET ST
    WESTERN SPRINGS, IL
    ZIP 60558
  • Facility Phone: 708 246-7530
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID MANKOFF
  • NPI Number: 1669803466
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2036069
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8529
Street 14 GARDEN MARKET ST
City WESTERN SPRINGS
State IL
ZIP 60558
Phone 708 246-7530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Pharmacy
Lab Director DAVID MANKOFF

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