14D2037864 CLIA NUMBER - WALGREENS #12868

Laboratory Demographics

  • CLIA Code: 14D2037864
  • Facility Name: WALGREENS #12868
  • Facility Address: 104 N LOMBARD ST
    MAHOMET, IL
    ZIP 61853
  • Facility Phone: 217 586-3460
  • Facility Type: Other - COVID TESTING
  • Facility Type: Waiver
  • Lab Director: MEGAN ASHER
  • NPI Number: 1710119201
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2037864
LAB Type Other - COVID TESTING
Facility Name WALGREENS #12868
Street 104 N LOMBARD ST
City MAHOMET
State IL
ZIP 61853
Phone 217 586-3460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Other - COVID TESTING
Lab Director MEGAN ASHER

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