14D2051388 CLIA NUMBER - WALGREENS #09924

Laboratory Demographics

  • CLIA Code: 14D2051388
  • Facility Name: WALGREENS #09924
  • Facility Address: 390 E 162ND ST
    SOUTH HOLLAND, IL
    ZIP 60473
  • Facility Phone: 708 339-7799
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD A. TREMMEL
  • NPI Number: 1790790921
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2051388
LAB Type Pharmacy
Facility Name WALGREENS #09924
Street 390 E 162ND ST
City SOUTH HOLLAND
State IL
ZIP 60473
Phone 708 339-7799
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Pharmacy
Lab Director RICHARD A. TREMMEL

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