14D2215644 CLIA NUMBER - WALGREENS #10122

Laboratory Demographics

  • CLIA Code: 14D2215644
  • Facility Name: WALGREENS #10122
  • Facility Address: 951 N IL ROUTE 83
    MUNDELEIN, IL
    ZIP 60060
  • Facility Phone: 847 566-7208
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TATYANA BENES
  • NPI Number: 1205019338
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2215644
LAB Type Pharmacy
Facility Name WALGREENS #10122
Street 951 N IL ROUTE 83
City MUNDELEIN
State IL
ZIP 60060
Phone 847 566-7208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Pharmacy
Lab Director TATYANA BENES

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