14D2036125 CLIA NUMBER - MARIANO'S PHARMACY #8514

Laboratory Demographics

  • CLIA Code: 14D2036125
  • Facility Name: MARIANO'S PHARMACY #8514
  • Facility Address: 1350 EAST ROUTE 22
    LAKE ZURICH, IL
    ZIP 60047
  • Facility Phone: 847 438-4012
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FRANK DEBENEDICTIS
  • NPI Number: 1982035101
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2036125
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8514
Street 1350 EAST ROUTE 22
City LAKE ZURICH
State IL
ZIP 60047
Phone 847 438-4012
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 FRANK DEBENEDICTIS

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