14D2108696 CLIA NUMBER - MARIANO'S PHARMACY

Laboratory Demographics

  • CLIA Code: 14D2108696
  • Facility Name: MARIANO'S PHARMACY
  • Facility Address: 9504 WEST 142ND ST
    ORLAND PARK, IL
    ZIP 60462
  • Facility Phone: 708 226-0027
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DONNA DIAN
  • NPI Number: 1548625551
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2108696
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY
Street 9504 WEST 142ND ST
City ORLAND PARK
State IL
ZIP 60462
Phone 708 226-0027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type Pharmacy
Lab Director DONNA DIAN

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