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14D2215299 CLIA NUMBER - WALGREENS #04069

Laboratory Demographics

CLIA Number: 14D2215299

Facility Name: WALGREENS #04069

Facility Address:
125 N NELTNOR BLVD
WEST CHICAGO, IL
ZIP 60185
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Facility Phone Number: 630 293-8951

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1053326223

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 14D2215299
LAB Type Pharmacy
Facility Name WALGREENS #04069
Street 125 N NELTNOR BLVD
City WEST CHICAGO
State IL
ZIP 60185
Phone 630 293-8951
CertificateType 4
CertificateEffectiveDate 3/2/2023
CertificateExpirationDate 3/1/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024