14D2223273 CLIA NUMBER - CVS/PHARMACY #03110 BUSSE CVS, LLC

Laboratory Demographics

  • CLIA Code: 14D2223273
  • Facility Name: CVS/PHARMACY #03110 BUSSE CVS, LLC
  • Facility Address: 1002 S BUSSE RD
    MOUNT PROSPECT, IL
    ZIP 60056
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HARDIK THAKKAR
  • NPI Number: 1740384684
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2223273
LAB Type Pharmacy
Facility Name CVS/PHARMACY #03110 BUSSE CVS, LLC
Street 1002 S BUSSE RD
City MOUNT PROSPECT
State IL
ZIP 60056
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Pharmacy
Lab Director HARDIK THAKKAR

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