14D2219910 CLIA NUMBER - WALGREENS #11411

Laboratory Demographics

  • CLIA Code: 14D2219910
  • Facility Name: WALGREENS #11411
  • Facility Address: 395 S DIVISION ST
    HARVARD, IL
    ZIP 60033
  • Facility Phone: (815) 943-4376
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATEL PRADUMAN
  • NPI Number: 1013655430
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2219910
LAB Type Pharmacy
Facility Name WALGREENS #11411
Street 395 S DIVISION ST
City HARVARD
State IL
ZIP 60033
Phone 8159434376
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director PATEL PRADUMAN

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This page was last updated on: 5/18/2026