14D2227854 CLIA NUMBER - WALGREENS #06439

Laboratory Demographics

  • CLIA Code: 14D2227854
  • Facility Name: WALGREENS #06439
  • Facility Address: 17955 WOLF RD
    ORLAND PARK, IL
    ZIP 60467
  • Facility Phone: 708 478-3758
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMAH A. KUTOM
  • NPI Number: 1326053554
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2227854
LAB Type Pharmacy
Facility Name WALGREENS #06439
Street 17955 WOLF RD
City ORLAND PARK
State IL
ZIP 60467
Phone 708 478-3758
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director SAMAH A. KUTOM

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