14D2056290 CLIA NUMBER - WALGREENS 00528

Laboratory Demographics

  • CLIA Code: 14D2056290
  • Facility Name: WALGREENS 00528
  • Facility Address: 296 E DEERPATH
    LAKE FOREST, IL
    ZIP 60045
  • Facility Phone: 847 234-2413
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIM N. HOME
  • NPI Number: 1508871633
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2056290
LAB Type Pharmacy
Facility Name WALGREENS 00528
Street 296 E DEERPATH
City LAKE FOREST
State IL
ZIP 60045
Phone 847 234-2413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Pharmacy
Lab Director JIM N. HOME

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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