14D2234605 CLIA NUMBER - WALGREENS #12623

Laboratory Demographics

  • CLIA Code: 14D2234605
  • Facility Name: WALGREENS #12623
  • Facility Address: 1180 S ROSELLE RD
    SCHAUMBURG, IL
    ZIP 60193
  • Facility Phone: 847 895-8646
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW KANG
  • NPI Number: 1013922319
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2234605
LAB Type Pharmacy
Facility Name WALGREENS #12623
Street 1180 S ROSELLE RD
City SCHAUMBURG
State IL
ZIP 60193
Phone 847 895-8646
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2023
Certificate Expiration Date 8/31/2025
Facility Type Pharmacy
Lab Director MATTHEW KANG

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This page was last updated on: 3/20/2025