14D2036084 CLIA NUMBER - OSCO DRUG #0202

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Laboratory Demographics

CLIA Number: 14D2036084

Facility Name: OSCO DRUG #0202

Facility Address:
2550 N CLYBOURN AVE
CHICAGO, IL
ZIP 60614
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Facility Phone Number: 773 348-7421

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558790311

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	14D2036084
LAB Type	Pharmacy
Facility Name	OSCO DRUG #0202
Street	2550 N CLYBOURN AVE
City	CHICAGO
State	IL
ZIP	60614
Phone	773 348-7421
CertificateType	4
CertificateEffectiveDate	1/31/2024
CertificateExpirationDate	1/30/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024