14D2049922 CLIA NUMBER - WALGREENS #05235

Laboratory Demographics

  • CLIA Code: 14D2049922
  • Facility Name: WALGREENS #05235
  • Facility Address: 6412 ROOSEVELT RD
    OAK PARK, IL
    ZIP 60304
  • Facility Phone: 708 386-9359
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FELIX VELAZQUEZ
  • NPI Number: 1003821208
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2049922
LAB Type Pharmacy
Facility Name WALGREENS #05235
Street 6412 ROOSEVELT RD
City OAK PARK
State IL
ZIP 60304
Phone 708 386-9359
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2025
Certificate Expiration Date 9/2/2027
Facility Type Pharmacy
Lab Director FELIX VELAZQUEZ

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