14D2056260 CLIA NUMBER - WALGREENS #15080

Laboratory Demographics

  • CLIA Code: 14D2056260
  • Facility Name: WALGREENS #15080
  • Facility Address: 5555 W 79TH ST
    BURBANK, IL
    ZIP 60459
  • Facility Phone: 708 499-3755
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BINITABAHEN A. PATEL
  • NPI Number: 1417962663
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2056260
LAB Type Pharmacy
Facility Name WALGREENS #15080
Street 5555 W 79TH ST
City BURBANK
State IL
ZIP 60459
Phone 708 499-3755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Pharmacy
Lab Director BINITABAHEN A. PATEL

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