14D2036108 CLIA NUMBER - MARIANO'S PHARMACY #8523

Laboratory Demographics

  • CLIA Code: 14D2036108
  • Facility Name: MARIANO'S PHARMACY #8523
  • Facility Address: 6655 GRAND AVE
    GURNEE, IL
    ZIP 60031
  • Facility Phone: 847 856-8701
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY BHULLAR
  • NPI Number: 1487085288
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2036108
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8523
Street 6655 GRAND AVE
City GURNEE
State IL
ZIP 60031
Phone 847 856-8701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Pharmacy
Lab Director KIMBERLY BHULLAR

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