14D2288122 CLIA NUMBER - WALGREENS 21247

Laboratory Demographics

  • CLIA Code: 14D2288122
  • Facility Name: WALGREENS 21247
  • Facility Address: 15940 KEDZIE AVE
    MARKHAM, IL
    ZIP 60428
  • Facility Phone: 708 339-1184
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDWARD M. CHEN
  • NPI Number: 1417962549
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2288122
LAB Type Pharmacy
Facility Name WALGREENS 21247
Street 15940 KEDZIE AVE
City MARKHAM
State IL
ZIP 60428
Phone 708 339-1184
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 EDWARD M. CHEN

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