Healther Providers Data Logo

14D2218220 CLIA NUMBER - CVS/PHARMACY #16304 HIGHLAND PARK CVS, LLC

Laboratory Demographics

CLIA Number: 14D2218220

Facility Name: CVS/PHARMACY #16304 HIGHLAND PARK CVS, LLC

Facility Address:
2333 63RD ST
WOODRIDGE, IL
ZIP 60517
Get Directions

Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1427070234

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 14D2218220
LAB Type Pharmacy
Facility Name CVS/PHARMACY #16304 HIGHLAND PARK CVS, LLC
Street 2333 63RD ST
City WOODRIDGE
State IL
ZIP 60517
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 3/26/2023
CertificateExpirationDate 3/25/2025
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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