14D2051389 CLIA NUMBER - WALGREENS #03948

Laboratory Demographics

  • CLIA Code: 14D2051389
  • Facility Name: WALGREENS #03948
  • Facility Address: 5140 W DIVERSEY AVE
    CHICAGO, IL
    ZIP 60639
  • Facility Phone: 773 685-8759
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARFARAZ PATEL
  • NPI Number: 1609882174
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2051389
LAB Type Pharmacy
Facility Name WALGREENS #03948
Street 5140 W DIVERSEY AVE
City CHICAGO
State IL
ZIP 60639
Phone 773 685-8759
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Pharmacy
Lab Director SARFARAZ PATEL

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