14D2115750 CLIA NUMBER - MARIANO'S PHARMACY #8518

Laboratory Demographics

  • CLIA Code: 14D2115750
  • Facility Name: MARIANO'S PHARMACY #8518
  • Facility Address: 25 WAUKEGAN AVE
    GLENVIEW, IL
    ZIP 60025
  • Facility Phone: 847 724-4821
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUMY JOHNY
  • NPI Number: 1447651674
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2115750
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8518
Street 25 WAUKEGAN AVE
City GLENVIEW
State IL
ZIP 60025
Phone 847 724-4821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Pharmacy
Lab Director SUMY JOHNY

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