14D2069308 CLIA NUMBER - WALGREENS #15364

Laboratory Demographics

  • CLIA Code: 14D2069308
  • Facility Name: WALGREENS #15364
  • Facility Address: 635 CHICAGO AVE
    EVANSTON, IL
    ZIP 60202
  • Facility Phone: 847 864-8120
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA K. TRAN
  • NPI Number: 1972518108
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2069308
LAB Type Pharmacy
Facility Name WALGREENS #15364
Street 635 CHICAGO AVE
City EVANSTON
State IL
ZIP 60202
Phone 847 864-8120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Pharmacy
Lab Director LISA K. TRAN

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