14D2220815 CLIA NUMBER - WALGREENS #03009

Laboratory Demographics

  • CLIA Code: 14D2220815
  • Facility Name: WALGREENS #03009
  • Facility Address: 545 E NORRIS DR
    OTTAWA, IL
    ZIP 61350
  • Facility Phone: 815 433-0485
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT J. MAZIARKA
  • NPI Number: 1962417097
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2220815
LAB Type Pharmacy
Facility Name WALGREENS #03009
Street 545 E NORRIS DR
City OTTAWA
State IL
ZIP 61350
Phone 815 433-0485
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Pharmacy
Lab Director ROBERT J. MAZIARKA

Download Record

Download this CLIA record record in Text format: Export

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

Download this CLIA record record in XML format: Export

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