14D2212716 CLIA NUMBER - WALGREENS #12624

Laboratory Demographics

  • CLIA Code: 14D2212716
  • Facility Name: WALGREENS #12624
  • Facility Address: 2501 75TH ST
    WOODRIDGE, IL
    ZIP 60517
  • Facility Phone: 630 910-6142
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY DEMPSEY
  • NPI Number: 1790790954
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2212716
LAB Type Pharmacy
Facility Name WALGREENS #12624
Street 2501 75TH ST
City WOODRIDGE
State IL
ZIP 60517
Phone 630 910-6142
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Pharmacy
Lab Director ASHLEY DEMPSEY

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