14D2058674 CLIA NUMBER - WALGREENS #09515

Laboratory Demographics

  • CLIA Code: 14D2058674
  • Facility Name: WALGREENS #09515
  • Facility Address: 1301 AVENUE OF THE CITIES
    EAST MOLINE, IL
    ZIP 61244
  • Facility Phone: (309) 755-0325
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FATIMA SHAH
  • NPI Number: 1023023132
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2058674
LAB Type Pharmacy
Facility Name WALGREENS #09515
Street 1301 AVENUE OF THE CITIES
City EAST MOLINE
State IL
ZIP 61244
Phone 3097550325
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director FATIMA SHAH

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This page was last updated on: 5/18/2026