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14D2046324 CLIA NUMBER - U I C UNIV OF IL COLLEGE OF PHARMACY AT ROCKFORD

Laboratory Demographics

CLIA Number: 14D2046324

Facility Name: U I C UNIV OF IL COLLEGE OF PHARMACY AT ROCKFORD

Facility Address:
1601 PARKVIEW AVE, RM A302
ROCKFORD, IL
ZIP 61107
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Facility Phone Number: 815 395-5937

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1336187749

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 14D2046324
LAB Type Pharmacy
Facility Name U I C UNIV OF IL COLLEGE OF PHARMACY AT ROCKFORD
Street 1601 PARKVIEW AVE, RM A302
City ROCKFORD
State IL
ZIP 61107
Phone 815 395-5937
CertificateType 4
CertificateEffectiveDate 8/30/2022
CertificateExpirationDate 8/29/2024
FacilityType Waiver

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