14D2080326 CLIA NUMBER - OSCO DRUG #3538

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Laboratory Demographics

CLIA Number: 14D2080326

Facility Name: OSCO DRUG #3538

Facility Address:
1763 W HOWARD ST
CHICAGO, IL
ZIP 60626
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Facility Phone Number: 773 274-1293

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871910190

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	14D2080326
LAB Type	Pharmacy
Facility Name	OSCO DRUG #3538
Street	1763 W HOWARD ST
City	CHICAGO
State	IL
ZIP	60626
Phone	773 274-1293
CertificateType	4
CertificateEffectiveDate	7/3/2022
CertificateExpirationDate	7/2/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024