14D2289092 CLIA NUMBER - WALGREENS 15044

Laboratory Demographics

  • CLIA Code: 14D2289092
  • Facility Name: WALGREENS 15044
  • Facility Address: 680 N LAKE SHORE DR - STE 108
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 943-2224
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATASA RISTIC
  • NPI Number: 1851609341
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2289092
LAB Type Pharmacy
Facility Name WALGREENS 15044
Street 680 N LAKE SHORE DR - STE 108
City CHICAGO
State IL
ZIP 60611
Phone 312 943-2224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2023
Certificate Expiration Date 9/5/2025
Facility Type Pharmacy
Lab Director NATASA RISTIC

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This page was last updated on: 6/4/2025