14D2112094 CLIA NUMBER - OAK STREET HEALTH - ENGLEWOOD CENTER

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Laboratory Demographics

CLIA Number: 14D2112094

Facility Name: OAK STREET HEALTH - ENGLEWOOD CENTER

Facility Address:
850 WEST 63RD ST
CHICAGO, IL
ZIP 60621
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Facility Phone Number: 773 377-7304

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184153157

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	14D2112094
LAB Type	Physician Office
Facility Name	OAK STREET HEALTH - ENGLEWOOD CENTER
Street	850 WEST 63RD ST
City	CHICAGO
State	IL
ZIP	60621
Phone	773 377-7304
CertificateType	4
CertificateEffectiveDate	4/21/2024
CertificateExpirationDate	4/20/2026
FacilityType	Waiver

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