14D2283737 CLIA NUMBER - CVS/PHARMACY #10889 HIGHLAND PARK CVS LLC

Laboratory Demographics

  • CLIA Code: 14D2283737
  • Facility Name: CVS/PHARMACY #10889 HIGHLAND PARK CVS LLC
  • Facility Address: 115 E MAPLE ST
    NEW LENOX, IL
    ZIP 60451
  • Facility Phone: 815 215-3183
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER KANTORSKI
  • NPI Number: 1699245662
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2283737
LAB Type Pharmacy
Facility Name CVS/PHARMACY #10889 HIGHLAND PARK CVS LLC
Street 115 E MAPLE ST
City NEW LENOX
State IL
ZIP 60451
Phone 815 215-3183
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2023
Certificate Expiration Date 6/12/2025
Facility Type Pharmacy
Lab Director JENNIFER KANTORSKI

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