14D2058667 CLIA NUMBER - WALGREENS #04333

Laboratory Demographics

  • CLIA Code: 14D2058667
  • Facility Name: WALGREENS #04333
  • Facility Address: 301 30TH AVE
    EAST MOLINE, IL
    ZIP 61244
  • Facility Phone: 309 755-4857
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HAILEY J. O NEILL
  • NPI Number: 1154336329
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2058667
LAB Type Pharmacy
Facility Name WALGREENS #04333
Street 301 30TH AVE
City EAST MOLINE
State IL
ZIP 61244
Phone 309 755-4857
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director HAILEY J. O NEILL

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