14D2087612 CLIA NUMBER - WALGREENS 16085

Laboratory Demographics

  • CLIA Code: 14D2087612
  • Facility Name: WALGREENS 16085
  • Facility Address: 100 W RANDOLPH ST
    CHICAGO, IL
    ZIP 60601
  • Facility Phone: 312 525-3984
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MILAN M. SHAH
  • NPI Number: 1083015622
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2087612
LAB Type Pharmacy
Facility Name WALGREENS 16085
Street 100 W RANDOLPH ST
City CHICAGO
State IL
ZIP 60601
Phone 312 525-3984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2023
Certificate Expiration Date 8/22/2025
Facility Type Pharmacy
Lab Director MILAN M. SHAH

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This page was last updated on: 3/20/2025