14D2288118 CLIA NUMBER - WALGREENS 04147

Laboratory Demographics

  • CLIA Code: 14D2288118
  • Facility Name: WALGREENS 04147
  • Facility Address: 1546 M CENTRAL AVE
    CHICAGO, IL
    ZIP 60651
  • Facility Phone: 773 622-8185
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH E. REID-TATE
  • NPI Number: 1154336386
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2288118
LAB Type Pharmacy
Facility Name WALGREENS 04147
Street 1546 M CENTRAL AVE
City CHICAGO
State IL
ZIP 60651
Phone 773 622-8185
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 ELIZABETH E. REID-TATE

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