14D2056283 CLIA NUMBER - WALGREENS #05034

Laboratory Demographics

  • CLIA Code: 14D2056283
  • Facility Name: WALGREENS #05034
  • Facility Address: 6315 S KEDZIE AVE
    CHICAGO, IL
    ZIP 60629
  • Facility Phone: 773 776-4040
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL E. KRZYZANIAK
  • NPI Number: 1609881739
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2056283
LAB Type Pharmacy
Facility Name WALGREENS #05034
Street 6315 S KEDZIE AVE
City CHICAGO
State IL
ZIP 60629
Phone 773 776-4040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Pharmacy
Lab Director MICHAEL E. KRZYZANIAK

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