14D2219775 CLIA NUMBER - WALGREENS #04355

Laboratory Demographics

  • CLIA Code: 14D2219775
  • Facility Name: WALGREENS #04355
  • Facility Address: 12 N NORTHWEST HWY
    PALATINE, IL
    ZIP 60067
  • Facility Phone: 847 359-3624
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THAO TRANG HO
  • NPI Number: 1447265582
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2219775
LAB Type Pharmacy
Facility Name WALGREENS #04355
Street 12 N NORTHWEST HWY
City PALATINE
State IL
ZIP 60067
Phone 847 359-3624
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Pharmacy
Lab Director THAO TRANG HO

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