14D2051401 CLIA NUMBER - WALGREENS 15921

Laboratory Demographics

  • CLIA Code: 14D2051401
  • Facility Name: WALGREENS 15921
  • Facility Address: 410 N MICHIGAN AVE
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 321-0951
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAUSHIK BHATIA
  • NPI Number: 1144235391
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2051401
LAB Type Pharmacy
Facility Name WALGREENS 15921
Street 410 N MICHIGAN AVE
City CHICAGO
State IL
ZIP 60611
Phone 312 321-0951
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Pharmacy
Lab Director KAUSHIK BHATIA

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