14D2291078 CLIA NUMBER - WALGREENS 07687

Laboratory Demographics

  • CLIA Code: 14D2291078
  • Facility Name: WALGREENS 07687
  • Facility Address: 3320 W FULLERTON AVE
    CHICAGO, IL
    ZIP 60647
  • Facility Phone: 773 252-8346
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW S. JEON
  • NPI Number: 1194077784
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2291078
LAB Type Pharmacy
Facility Name WALGREENS 07687
Street 3320 W FULLERTON AVE
City CHICAGO
State IL
ZIP 60647
Phone 773 252-8346
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2023
Certificate Expiration Date 10/3/2025
Facility Type Pharmacy
Lab Director ANDREW S. JEON

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