14D2288112 CLIA NUMBER - WALGREENS 02840

Laboratory Demographics

  • CLIA Code: 14D2288112
  • Facility Name: WALGREENS 02840
  • Facility Address: 1500 W WILSON AVE
    CHICAGO, IL
    ZIP 60640
  • Facility Phone: 773 907-8995
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHAEL K. PINCSAK
  • NPI Number: 1518972769
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2288112
LAB Type Pharmacy
Facility Name WALGREENS 02840
Street 1500 W WILSON AVE
City CHICAGO
State IL
ZIP 60640
Phone 773 907-8995
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Pharmacy
Lab Director RACHAEL K. PINCSAK

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