14D2283009 CLIA NUMBER - CVS/PHARMACY #06866 HIGHLAND PARK CVS, LLC

Laboratory Demographics

  • CLIA Code: 14D2283009
  • Facility Name: CVS/PHARMACY #06866 HIGHLAND PARK CVS, LLC
  • Facility Address: 100 ADMIRAL TROST RD
    COLUMBIA, IL
    ZIP 62236
  • Facility Phone: 618 281-6400
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER KIENLEN
  • NPI Number: 1558464222
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2283009
LAB Type Pharmacy
Facility Name CVS/PHARMACY #06866 HIGHLAND PARK CVS, LLC
Street 100 ADMIRAL TROST RD
City COLUMBIA
State IL
ZIP 62236
Phone 618 281-6400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Pharmacy
Lab Director JENNIFER KIENLEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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