14D2049912 CLIA NUMBER - WALGREENS #12584

Laboratory Demographics

  • CLIA Code: 14D2049912
  • Facility Name: WALGREENS #12584
  • Facility Address: 1050 WAUKEGAN RD
    NORTHBROOK, IL
    ZIP 60062
  • Facility Phone: 847 272-3155
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIM MINA
  • NPI Number: 1235144361
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2049912
LAB Type Pharmacy
Facility Name WALGREENS #12584
Street 1050 WAUKEGAN RD
City NORTHBROOK
State IL
ZIP 60062
Phone 847 272-3155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Pharmacy
Lab Director KIM MINA

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This page was last updated on: 3/20/2025