14D2228076 CLIA NUMBER - WALGREENS #04460

Laboratory Demographics

  • CLIA Code: 14D2228076
  • Facility Name: WALGREENS #04460
  • Facility Address: 1295 LILY CACHE LN
    BOLINGBROOK, IL
    ZIP 60490
  • Facility Phone: 630 226-5839
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IULIANA DUMITRESCU
  • NPI Number: 1417962689
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2228076
LAB Type Pharmacy
Facility Name WALGREENS #04460
Street 1295 LILY CACHE LN
City BOLINGBROOK
State IL
ZIP 60490
Phone 630 226-5839
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Pharmacy
Lab Director IULIANA DUMITRESCU

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