14D2051403 CLIA NUMBER - WALGREENS #04540

Laboratory Demographics

  • CLIA Code: 14D2051403
  • Facility Name: WALGREENS #04540
  • Facility Address: 901 W TOUHY AVE
    PARK RIDGE, IL
    ZIP 60068
  • Facility Phone: (847) 384-0125
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE E. DALTON
  • NPI Number: 1326053596
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2051403
LAB Type Pharmacy
Facility Name WALGREENS #04540
Street 901 W TOUHY AVE
City PARK RIDGE
State IL
ZIP 60068
Phone 8473840125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director NICOLE E. DALTON

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This page was last updated on: 5/18/2026