14D2182072 CLIA NUMBER - PHARMACY ONE PLUS THURAYA INC

Laboratory Demographics

  • CLIA Code: 14D2182072
  • Facility Name: PHARMACY ONE PLUS THURAYA INC
  • Facility Address: 4753-55 N KEDZIE AVE
    CHICAGO, IL
    ZIP 60625
  • Facility Phone: 773 267-5050
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN M. KOZELUH
  • NPI Number: 1306857941
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2182072
LAB Type Pharmacy
Facility Name PHARMACY ONE PLUS THURAYA INC
Street 4753-55 N KEDZIE AVE
City CHICAGO
State IL
ZIP 60625
Phone 773 267-5050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2024
Certificate Expiration Date 4/14/2026
Facility Type Pharmacy
Lab Director KEVIN M. KOZELUH

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