14D2036131 CLIA NUMBER - MARIANO'S PHARMACY #8521

Laboratory Demographics

  • CLIA Code: 14D2036131
  • Facility Name: MARIANO'S PHARMACY #8521
  • Facility Address: 450 HALF DAY RD
    BUFFALO GROVE, IL
    ZIP 60089
  • Facility Phone: 847 634-1130
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARINA SIMONOFF
  • NPI Number: 1740611540
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2036131
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8521
Street 450 HALF DAY RD
City BUFFALO GROVE
State IL
ZIP 60089
Phone 847 634-1130
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 MARINA SIMONOFF

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