14D2221575 CLIA NUMBER - WALGREENS #09347

Laboratory Demographics

  • CLIA Code: 14D2221575
  • Facility Name: WALGREENS #09347
  • Facility Address: 12659 S RIDGELAND AVE
    PALOS HEIGHTS, IL
    ZIP 60463
  • Facility Phone: 708 385-0218
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISHNAKANTH G. REDDY
  • NPI Number: 1750396867
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2221575
LAB Type Pharmacy
Facility Name WALGREENS #09347
Street 12659 S RIDGELAND AVE
City PALOS HEIGHTS
State IL
ZIP 60463
Phone 708 385-0218
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director KRISHNAKANTH G. REDDY

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