14D2049152 CLIA NUMBER - WALGREENS #05055

Laboratory Demographics

  • CLIA Code: 14D2049152
  • Facility Name: WALGREENS #05055
  • Facility Address: 12290 S PULASKI RD
    ALSIP, IL
    ZIP 60803
  • Facility Phone: 708 385-2006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD A. TREMMEL
  • NPI Number: 1437164613
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2049152
LAB Type Pharmacy
Facility Name WALGREENS #05055
Street 12290 S PULASKI RD
City ALSIP
State IL
ZIP 60803
Phone 708 385-2006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director RICHARD A. TREMMEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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