14D2174121 CLIA NUMBER - ST JUDE PHARMACY

Laboratory Demographics

  • CLIA Code: 14D2174121
  • Facility Name: ST JUDE PHARMACY
  • Facility Address: 301 MADISON ST - STE 114
    JOLIET, IL
    ZIP 60435
  • Facility Phone: 815 900-9000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMMED ALAHMED
  • NPI Number: 1790240489
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2174121
LAB Type Pharmacy
Facility Name ST JUDE PHARMACY
Street 301 MADISON ST - STE 114
City JOLIET
State IL
ZIP 60435
Phone 815 900-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Pharmacy
Lab Director MOHAMMED ALAHMED

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