14D2224895 CLIA NUMBER - WALGREENS #04463

Laboratory Demographics

  • CLIA Code: 14D2224895
  • Facility Name: WALGREENS #04463
  • Facility Address: 1201 W SPRING ST
    SOUTH ELGIN, IL
    ZIP 60177
  • Facility Phone: 847 695-0556
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: QUANG H. DINH
  • NPI Number: 1972518140
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2224895
LAB Type Pharmacy
Facility Name WALGREENS #04463
Street 1201 W SPRING ST
City SOUTH ELGIN
State IL
ZIP 60177
Phone 847 695-0556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2025
Certificate Expiration Date 5/16/2027
Facility Type Pharmacy
Lab Director QUANG H. DINH

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