14D2281999 CLIA NUMBER - CVS/PHARMACY #06833 HIGHLAND PARK CVS LLC

Laboratory Demographics

  • CLIA Code: 14D2281999
  • Facility Name: CVS/PHARMACY #06833 HIGHLAND PARK CVS LLC
  • Facility Address: 1 W EDWARDSVILLE RD
    WOOD RIVER, IL
    ZIP 62095
  • Facility Phone: 618 254-3610
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALLISON NICKLOW
  • NPI Number: 1710080585
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2281999
LAB Type Pharmacy
Facility Name CVS/PHARMACY #06833 HIGHLAND PARK CVS LLC
Street 1 W EDWARDSVILLE RD
City WOOD RIVER
State IL
ZIP 62095
Phone 618 254-3610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2025
Certificate Expiration Date 5/15/2027
Facility Type Pharmacy
Lab Director ALLISON NICKLOW

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