14D2138382 CLIA NUMBER - MARIANOS PHARMACY #8542

Laboratory Demographics

  • CLIA Code: 14D2138382
  • Facility Name: MARIANOS PHARMACY #8542
  • Facility Address: 2999 WAUKEGAN ROAD
    BANNOCKBURN, IL
    ZIP 60015
  • Facility Phone: 847 267-0364
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CINDY AU
  • NPI Number: 1659897098
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2138382
LAB Type Pharmacy
Facility Name MARIANOS PHARMACY #8542
Street 2999 WAUKEGAN ROAD
City BANNOCKBURN
State IL
ZIP 60015
Phone 847 267-0364
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Pharmacy
Lab Director CINDY AU

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