14D2056271 CLIA NUMBER - WALGREENS #03779

Home > CLIA Lookup > 14D2056271

Laboratory Demographics

CLIA Number: 14D2056271

Facility Name: WALGREENS #03779

Facility Address:
100 LAKE ST
MAYWOOD, IL
ZIP 60153
Get Directions

Facility Phone Number: 708 344-9885

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053326215

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	14D2056271
LAB Type	Pharmacy
Facility Name	WALGREENS #03779
Street	100 LAKE ST
City	MAYWOOD
State	IL
ZIP	60153
Phone	708 344-9885
CertificateType	4
CertificateEffectiveDate	9/8/2023
CertificateExpirationDate	9/7/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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