14D2252408 CLIA NUMBER - COMPREHENSIVE CARE PHARMACY ILLINOIS FAMILY PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 14D2252408
  • Facility Name: COMPREHENSIVE CARE PHARMACY ILLINOIS FAMILY PHARMACY LLC
  • Facility Address: 117 CLINTONIAN PLAZA
    BREESE, IL
    ZIP 62230
  • Facility Phone: 618 526-8040
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMANTHA J. DRYER
  • NPI Number: 1871504373
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2252408
LAB Type Pharmacy
Facility Name COMPREHENSIVE CARE PHARMACY ILLINOIS FAMILY PHARMACY LLC
Street 117 CLINTONIAN PLAZA
City BREESE
State IL
ZIP 62230
Phone 618 526-8040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Pharmacy
Lab Director SAMANTHA J. DRYER

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