14D2291419 CLIA NUMBER - WALGREENS 02828

Laboratory Demographics

  • CLIA Code: 14D2291419
  • Facility Name: WALGREENS 02828
  • Facility Address: 1602 KISHWAUKEE ST
    ROCKFORD, IL
    ZIP 61104
  • Facility Phone: 815 967-9054
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PETE PEPLOS
  • NPI Number: 1164437315
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2291419
LAB Type Pharmacy
Facility Name WALGREENS 02828
Street 1602 KISHWAUKEE ST
City ROCKFORD
State IL
ZIP 61104
Phone 815 967-9054
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2023
Certificate Expiration Date 10/9/2025
Facility Type Pharmacy
Lab Director PETE PEPLOS

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