14D2049151 CLIA NUMBER - WALGREENS #4937

Laboratory Demographics

  • CLIA Code: 14D2049151
  • Facility Name: WALGREENS #4937
  • Facility Address: 5753 N CANFIELD AVE
    CHICAGO, IL
    ZIP 60631
  • Facility Phone: 773 631-2851
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAMIAN WOLAK
  • NPI Number: 1962419044
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2049151
LAB Type Pharmacy
Facility Name WALGREENS #4937
Street 5753 N CANFIELD AVE
City CHICAGO
State IL
ZIP 60631
Phone 773 631-2851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Pharmacy
Lab Director DAMIAN WOLAK

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