14D2080319 CLIA NUMBER - OSCO DRUG #2504

Laboratory Demographics

  • CLIA Code: 14D2080319
  • Facility Name: OSCO DRUG #2504
  • Facility Address: 3243 W 115TH ST
    MERRIONETTE PARK, IL
    ZIP 60803
  • Facility Phone: 708 389-9021
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL RUSSELL
  • NPI Number: 1609293539
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2080319
LAB Type Pharmacy
Facility Name OSCO DRUG #2504
Street 3243 W 115TH ST
City MERRIONETTE PARK
State IL
ZIP 60803
Phone 708 389-9021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2024
Certificate Expiration Date 7/2/2026
Facility Type Pharmacy
Lab Director RACHEL RUSSELL

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