14D2287980 CLIA NUMBER - WALGREENS 04986

Laboratory Demographics

  • CLIA Code: 14D2287980
  • Facility Name: WALGREENS 04986
  • Facility Address: 4745 W BELMONT AVE
    CHICAGO, IL
    ZIP 60641
  • Facility Phone: 773 481-0211
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAVIER P. COSME
  • NPI Number: 1669489647
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2287980
LAB Type Pharmacy
Facility Name WALGREENS 04986
Street 4745 W BELMONT AVE
City CHICAGO
State IL
ZIP 60641
Phone 773 481-0211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Pharmacy
Lab Director JAVIER P. COSME

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