14D2038306 CLIA NUMBER - WALGREENS #04865

Laboratory Demographics

  • CLIA Code: 14D2038306
  • Facility Name: WALGREENS #04865
  • Facility Address: 515 CARLYLE AVE
    BELLEVILLE, IL
    ZIP 62221
  • Facility Phone: 618 222-1827
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. APPLE
  • NPI Number: 1629083803
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2038306
LAB Type Pharmacy
Facility Name WALGREENS #04865
Street 515 CARLYLE AVE
City BELLEVILLE
State IL
ZIP 62221
Phone 618 222-1827
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Pharmacy
Lab Director JENNIFER L. APPLE

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