14D2196599 CLIA NUMBER - SIMPLY PURE R X

Laboratory Demographics

  • CLIA Code: 14D2196599
  • Facility Name: SIMPLY PURE R X
  • Facility Address: 1607 BONSON AVE
    EVANSTON, IL
    ZIP 60201
  • Facility Phone: 847 227-8020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FADI F. MUSLEH
  • NPI Number: 1750749297
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2196599
LAB Type Pharmacy
Facility Name SIMPLY PURE R X
Street 1607 BONSON AVE
City EVANSTON
State IL
ZIP 60201
Phone 847 227-8020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Pharmacy
Lab Director FADI F. MUSLEH

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