14D2234644 CLIA NUMBER - WALGREENS #04519

Laboratory Demographics

  • CLIA Code: 14D2234644
  • Facility Name: WALGREENS #04519
  • Facility Address: 1320 E 47TH ST
    CHICAGO, IL
    ZIP 60653
  • Facility Phone: 773 373-6147
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH J. MANCARI
  • NPI Number: 1164437349
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2234644
LAB Type Pharmacy
Facility Name WALGREENS #04519
Street 1320 E 47TH ST
City CHICAGO
State IL
ZIP 60653
Phone 773 373-6147
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Pharmacy
Lab Director JOSEPH J. MANCARI

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