14D2058494 CLIA NUMBER - WALGREENS #06641

Laboratory Demographics

  • CLIA Code: 14D2058494
  • Facility Name: WALGREENS #06641
  • Facility Address: 1614 W 47TH ST
    CHICAGO, IL
    ZIP 60609
  • Facility Phone: 773 247-3051
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NIRAVKUMAR PATEL
  • NPI Number: 1346255577
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2058494
LAB Type Pharmacy
Facility Name WALGREENS #06641
Street 1614 W 47TH ST
City CHICAGO
State IL
ZIP 60609
Phone 773 247-3051
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Pharmacy
Lab Director NIRAVKUMAR PATEL

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