14D2285814 CLIA NUMBER - CVS/PHARMACY #07168 HIGHLAND PARK CVS LLC

Laboratory Demographics

  • CLIA Code: 14D2285814
  • Facility Name: CVS/PHARMACY #07168 HIGHLAND PARK CVS LLC
  • Facility Address: 1725 W BOUGHTON RD
    BOLINGBROOK, IL
    ZIP 60490
  • Facility Phone: 630 759-6320
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AYAH ABUSHAMAT
  • NPI Number: 1801990759
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2285814
LAB Type Pharmacy
Facility Name CVS/PHARMACY #07168 HIGHLAND PARK CVS LLC
Street 1725 W BOUGHTON RD
City BOLINGBROOK
State IL
ZIP 60490
Phone 630 759-6320
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Pharmacy
Lab Director AYAH ABUSHAMAT

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