14D2056277 CLIA NUMBER - WALGREENS #01449

Laboratory Demographics

  • CLIA Code: 14D2056277
  • Facility Name: WALGREENS #01449
  • Facility Address: 8000 BROADVIEW VILLAGE SQUARE
    BROADVIEW, IL
    ZIP 60155
  • Facility Phone: 708 410-2957
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SOUHANDA ELIA SEFIN
  • NPI Number: 1093720203
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2056277
LAB Type Pharmacy
Facility Name WALGREENS #01449
Street 8000 BROADVIEW VILLAGE SQUARE
City BROADVIEW
State IL
ZIP 60155
Phone 708 410-2957
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Pharmacy
Lab Director SOUHANDA ELIA SEFIN

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