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14D2227761 CLIA NUMBER - WALGREENS #05284

Laboratory Demographics

CLIA Number: 14D2227761

Facility Name: WALGREENS #05284

Facility Address:
1301 E ALGONQUIN RD
ALGONQUIN, IL
ZIP 60102
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Facility Phone Number: 847 658-2904

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1780699918

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 14D2227761
LAB Type Physician Office
Facility Name WALGREENS #05284
Street 1301 E ALGONQUIN RD
City ALGONQUIN
State IL
ZIP 60102
Phone 847 658-2904
CertificateType 4
CertificateEffectiveDate 6/16/2023
CertificateExpirationDate 6/15/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024