14D2283710 CLIA NUMBER - CVS/PHARMACY #00834 HIGHLAND PARK CVS LLC

Laboratory Demographics

  • CLIA Code: 14D2283710
  • Facility Name: CVS/PHARMACY #00834 HIGHLAND PARK CVS LLC
  • Facility Address: 8811 W 87TH ST
    HICKORY HILLS, IL
    ZIP 60457
  • Facility Phone: 708 430-6780
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONNA RANJBAR
  • NPI Number: 1104999002
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2283710
LAB Type Physician Office
Facility Name CVS/PHARMACY #00834 HIGHLAND PARK CVS LLC
Street 8811 W 87TH ST
City HICKORY HILLS
State IL
ZIP 60457
Phone 708 430-6780
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2023
Certificate Expiration Date 6/11/2025
Facility Type Physician Office
Lab Director DONNA RANJBAR

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This page was last updated on: 3/20/2025