14D2049933 CLIA NUMBER - WALGREENS #04494

Laboratory Demographics

  • CLIA Code: 14D2049933
  • Facility Name: WALGREENS #04494
  • Facility Address: 1649 W BELMONT AVE
    CHICAGO, IL
    ZIP 60657
  • Facility Phone: 773 281-8439
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIN TERRY
  • NPI Number: 1992711477
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2049933
LAB Type Pharmacy
Facility Name WALGREENS #04494
Street 1649 W BELMONT AVE
City CHICAGO
State IL
ZIP 60657
Phone 773 281-8439
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Pharmacy
Lab Director KRISTIN TERRY

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