14D2056826 CLIA NUMBER - WALGREENS # 04348

Laboratory Demographics

  • CLIA Code: 14D2056826
  • Facility Name: WALGREENS # 04348
  • Facility Address: 100 BEDFORD RD
    MORRIS, IL
    ZIP 60450
  • Facility Phone: 815 941-1284
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSE L. ORTIZ
  • NPI Number: 1427063692
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2056826
LAB Type Pharmacy
Facility Name WALGREENS # 04348
Street 100 BEDFORD RD
City MORRIS
State IL
ZIP 60450
Phone 815 941-1284
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Pharmacy
Lab Director JOSE L. ORTIZ

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