14D2036083 CLIA NUMBER - MARIANO'S PHARMACY #8520

Laboratory Demographics

  • CLIA Code: 14D2036083
  • Facility Name: MARIANO'S PHARMACY #8520
  • Facility Address: 3145 S ASHLAND AVE
    CHICAGO, IL
    ZIP 60608
  • Facility Phone: 773 247-3394
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAE KUNG
  • NPI Number: 1376974170
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2036083
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8520
Street 3145 S ASHLAND AVE
City CHICAGO
State IL
ZIP 60608
Phone 773 247-3394
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 MAE KUNG

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