14D2049165 CLIA NUMBER - WALGREENS #07360

Laboratory Demographics

  • CLIA Code: 14D2049165
  • Facility Name: WALGREENS #07360
  • Facility Address: 3220 W 111TH ST
    CHICAGO, IL
    ZIP 60655
  • Facility Phone: 773 239-2808
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDA R. SENESE
  • NPI Number: 1417962648
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2049165
LAB Type Pharmacy
Facility Name WALGREENS #07360
Street 3220 W 111TH ST
City CHICAGO
State IL
ZIP 60655
Phone 773 239-2808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director LINDA R. SENESE

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