14D2040885 CLIA NUMBER - WALGREENS #05137

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Laboratory Demographics

CLIA Number: 14D2040885

Facility Name: WALGREENS #05137

Facility Address:
1310 S 5TH ST
SPRINGFIELD, IL
ZIP 62703
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Facility Phone Number: 847 527-4238

Facility Type: Other - COVID-19 TEST SITE

Certificate Type: Waiver

NPI Number: 1891701397

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	14D2040885
LAB Type	Other - COVID-19 TEST SITE
Facility Name	WALGREENS #05137
Street	1310 S 5TH ST
City	SPRINGFIELD
State	IL
ZIP	62703
Phone	847 527-4238
CertificateType	4
CertificateEffectiveDate	4/7/2024
CertificateExpirationDate	4/6/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024