14D2056266 CLIA NUMBER - WALGREENS #06297

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Laboratory Demographics

CLIA Number: 14D2056266

Facility Name: WALGREENS #06297

Facility Address:
6016 W 63RD ST
CHICAGO, IL
ZIP 60638
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Facility Phone Number: 773 788-0180

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1255346573

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	14D2056266
LAB Type	Pharmacy
Facility Name	WALGREENS #06297
Street	6016 W 63RD ST
City	CHICAGO
State	IL
ZIP	60638
Phone	773 788-0180
CertificateType	4
CertificateEffectiveDate	5/12/2023
CertificateExpirationDate	5/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024