14D2132446 CLIA NUMBER - MARIANO'S PHARMACY #8538

Laboratory Demographics

  • CLIA Code: 14D2132446
  • Facility Name: MARIANO'S PHARMACY #8538
  • Facility Address: 3030 N BROADWAY ST
    CHICAGO, IL
    ZIP 60657
  • Facility Phone: 773 935-0713
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELENI PECZKOWSKI PHARMD
  • NPI Number: 1184074916
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2132446
LAB Type Pharmacy
Facility Name MARIANO'S PHARMACY #8538
Street 3030 N BROADWAY ST
City CHICAGO
State IL
ZIP 60657
Phone 773 935-0713
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2025
Certificate Expiration Date 6/19/2027
Facility Type Pharmacy
Lab Director ELENI PECZKOWSKI PHARMD

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