14D2218210 CLIA NUMBER - CVS/PHARMACY #16924 HIGHLAND PARK CVS, LLC

Laboratory Demographics

CLIA Number: 14D2218210

Facility Name: CVS/PHARMACY #16924 HIGHLAND PARK CVS, LLC

Facility Address:
750 S RANDALL RD
ALGONQUIN, IL
ZIP 60102
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1699797308

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	14D2218210
LAB Type	Pharmacy
Facility Name	CVS/PHARMACY #16924 HIGHLAND PARK CVS, LLC
Street	750 S RANDALL RD
City	ALGONQUIN
State	IL
ZIP	60102
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	3/26/2023
CertificateExpirationDate	3/25/2025
FacilityType	Waiver

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