14D2129000 CLIA NUMBER - MARIANO'S PHARMACY #8516

Laboratory Demographics

  • CLIA Code: 14D2129000
  • Facility Name: MARIANO'S PHARMACY #8516
  • Facility Address: 2112 N ASHLAND AVE
    CHICAGO, IL
    ZIP 60614
  • Facility Phone: 773 342-6680
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON YUEN
  • NPI Number: 1932519196
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2129000
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8516
Street 2112 N ASHLAND AVE
City CHICAGO
State IL
ZIP 60614
Phone 773 342-6680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Pharmacy
Lab Director JASON YUEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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