14D2216379 CLIA NUMBER - WALGREENS #11944

Laboratory Demographics

  • CLIA Code: 14D2216379
  • Facility Name: WALGREENS #11944
  • Facility Address: 315 N IL ROUTE 31
    CRYSTAL LAKE, IL
    ZIP 60012
  • Facility Phone: 815 404-2643
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA PANAGOPOULOS
  • NPI Number: 1487972881
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2216379
LAB Type Pharmacy
Facility Name WALGREENS #11944
Street 315 N IL ROUTE 31
City CRYSTAL LAKE
State IL
ZIP 60012
Phone 815 404-2643
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Pharmacy
Lab Director ANDREA PANAGOPOULOS

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This page was last updated on: 3/20/2025