14D2224479 CLIA NUMBER - WALGREENS #04502

Laboratory Demographics

  • CLIA Code: 14D2224479
  • Facility Name: WALGREENS #04502
  • Facility Address: 399 LAKE MARIAN RD
    CARPENTERSVILLE, IL
    ZIP 60110
  • Facility Phone: 847 428-7704
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BHUMIKA PATEL
  • NPI Number: 1356356570
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2224479
LAB Type Pharmacy
Facility Name WALGREENS #04502
Street 399 LAKE MARIAN RD
City CARPENTERSVILLE
State IL
ZIP 60110
Phone 847 428-7704
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Pharmacy
Lab Director BHUMIKA PATEL

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