14D2049921 CLIA NUMBER - WALGREENS #01504

Laboratory Demographics

  • CLIA Code: 14D2049921
  • Facility Name: WALGREENS #01504
  • Facility Address: 10639 S CICERO AVE
    OAK LAWN, IL
    ZIP 60453
  • Facility Phone: 708 424-3594
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBRA A. O CONNELL
  • NPI Number: 1609881820
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2049921
LAB Type Pharmacy
Facility Name WALGREENS #01504
Street 10639 S CICERO AVE
City OAK LAWN
State IL
ZIP 60453
Phone 708 424-3594
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director DEBRA A. O CONNELL

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