14D2058660 CLIA NUMBER - WALGREENS #09508

Laboratory Demographics

  • CLIA Code: 14D2058660
  • Facility Name: WALGREENS #09508
  • Facility Address: 221 N WESTERN AVE
    WEST PEORIA, IL
    ZIP 61604
  • Facility Phone: 309 673-0665
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RONDA J. SAVAGE
  • NPI Number: 1619982832
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2058660
LAB Type Pharmacy
Facility Name WALGREENS #09508
Street 221 N WESTERN AVE
City WEST PEORIA
State IL
ZIP 61604
Phone 309 673-0665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Pharmacy
Lab Director RONDA J. SAVAGE

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