14D2288018 CLIA NUMBER - WALGREENS 09438

Laboratory Demographics

CLIA Number: 14D2288018

Facility Name: WALGREENS 09438

Facility Address:
30N MICHIGAN AVE - LBBY1
CHICAGO, IL
ZIP 60602
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Facility Phone Number: 312 332-3540

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1619985934

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	14D2288018
LAB Type	Pharmacy
Facility Name	WALGREENS 09438
Street	30N MICHIGAN AVE - LBBY1
City	CHICAGO
State	IL
ZIP	60602
Phone	312 332-3540
CertificateType	4
CertificateEffectiveDate	8/21/2023
CertificateExpirationDate	8/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024