14D2215299 CLIA NUMBER - WALGREENS #04069

Laboratory Demographics

  • CLIA Code: 14D2215299
  • Facility Name: WALGREENS #04069
  • Facility Address: 125 N NELTNOR BLVD
    WEST CHICAGO, IL
    ZIP 60185
  • Facility Phone: 630 293-8951
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIE J. DANAN
  • NPI Number: 1053326223
  • Taxonomy: 333600000X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Pharmacy
Lab Director MARIE J. DANAN

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