14D2234645 CLIA NUMBER - WALGREENS #04664

Laboratory Demographics

  • CLIA Code: 14D2234645
  • Facility Name: WALGREENS #04664
  • Facility Address: 10345 W ROOSEVELT RD
    WESTCHESTER, IL
    ZIP 60154
  • Facility Phone: 708 681-4034
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY J. HAMPSON
  • NPI Number: 1356356539
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2234645
LAB Type Pharmacy
Facility Name WALGREENS #04664
Street 10345 W ROOSEVELT RD
City WESTCHESTER
State IL
ZIP 60154
Phone 708 681-4034
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 BRADLEY J. HAMPSON

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