14D2181618 CLIA NUMBER - WALGREENS #11154

Laboratory Demographics

  • CLIA Code: 14D2181618
  • Facility Name: WALGREENS #11154
  • Facility Address: 7113 CERMAK RD
    BERWYN, IL
    ZIP 60402
  • Facility Phone: 708 795-9030
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: SCOTT E. DIVENEY
  • NPI Number: 1952316077
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2181618
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #11154
Street 7113 CERMAK RD
City BERWYN
State IL
ZIP 60402
Phone 708 795-9030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director SCOTT E. DIVENEY

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