14D2184077 CLIA NUMBER - WALGREENS #05124

Laboratory Demographics

  • CLIA Code: 14D2184077
  • Facility Name: WALGREENS #05124
  • Facility Address: 8628 S COTTAGE GROVE AVE
    CHICAGO, IL
    ZIP 60619
  • Facility Phone: 847 527-4238
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: LATASHA N. GUY
  • NPI Number: 1407861537
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2184077
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #05124
Street 8628 S COTTAGE GROVE AVE
City CHICAGO
State IL
ZIP 60619
Phone 847 527-4238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director LATASHA N. GUY

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