14D2217295 CLIA NUMBER - WALGREENS #02137

Laboratory Demographics

  • CLIA Code: 14D2217295
  • Facility Name: WALGREENS #02137
  • Facility Address: 39023 N GREEN BAY RD
    BEACH PARK, IL
    ZIP 60087
  • Facility Phone: 847 599-2447
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SMITHA H. SHIVAPRASAD
  • NPI Number: 1487669594
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2217295
LAB Type Pharmacy
Facility Name WALGREENS #02137
Street 39023 N GREEN BAY RD
City BEACH PARK
State IL
ZIP 60087
Phone 847 599-2447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director SMITHA H. SHIVAPRASAD

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