14D2257869 CLIA NUMBER - CVS/PHARMACY #02663 HIGHLAND PARK CVS, LLC

Laboratory Demographics

  • CLIA Code: 14D2257869
  • Facility Name: CVS/PHARMACY #02663 HIGHLAND PARK CVS, LLC
  • Facility Address: 225 W COURT ST
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAGED JOUDEH
  • NPI Number: 1578504445
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2257869
LAB Type Pharmacy
Facility Name CVS/PHARMACY #02663 HIGHLAND PARK CVS, LLC
Street 225 W COURT ST
City KANKAKEE
State IL
ZIP 60901
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Pharmacy
Lab Director MAGED JOUDEH

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