14D2284476 CLIA NUMBER - WALGREENS HEALTH SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 14D2284476
  • Facility Name: WALGREENS HEALTH SERVICES, LLC
  • Facility Address: 4385 S ARCHER AVE - STE 101
    CHICAGO, IL
    ZIP 60632
  • Facility Phone: 773 247-6804
  • Facility Type: Other - HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: SASHIDARAN M. MOODLEY
  • NPI Number: 1508504325
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2284476
LAB Type Other - HEALTH CLINIC
Facility Name WALGREENS HEALTH SERVICES, LLC
Street 4385 S ARCHER AVE - STE 101
City CHICAGO
State IL
ZIP 60632
Phone 773 247-6804
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Other - HEALTH CLINIC
Lab Director SASHIDARAN M. MOODLEY

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