14D2234410 CLIA NUMBER - WALGREENS #03960

Laboratory Demographics

  • CLIA Code: 14D2234410
  • Facility Name: WALGREENS #03960
  • Facility Address: 7200 ROOSEVELT RD
    FOREST PARK, IL
    ZIP 60130
  • Facility Phone: 708 366-9534
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW C. KELLY
  • NPI Number: 1528073798
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2234410
LAB Type Pharmacy
Facility Name WALGREENS #03960
Street 7200 ROOSEVELT RD
City FOREST PARK
State IL
ZIP 60130
Phone 708 366-9534
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Pharmacy
Lab Director MATTHEW C. KELLY

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