14D2038530 CLIA NUMBER - WALGREENS #11542

Laboratory Demographics

  • CLIA Code: 14D2038530
  • Facility Name: WALGREENS #11542
  • Facility Address: 411 W LINCOLN AVE
    CHARLESTON, IL
    ZIP 61920
  • Facility Phone: 217 345-2233
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER LOOS
  • NPI Number: 1427063650
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2038530
LAB Type Pharmacy
Facility Name WALGREENS #11542
Street 411 W LINCOLN AVE
City CHARLESTON
State IL
ZIP 61920
Phone 217 345-2233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director CHRISTOPHER LOOS

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