14D2294067 CLIA NUMBER - WALGREENS 00259

Laboratory Demographics

  • CLIA Code: 14D2294067
  • Facility Name: WALGREENS 00259
  • Facility Address: 3358 N WESTERN AVE
    CHICAGO, IL
    ZIP 60618
  • Facility Phone: 773 327-2111
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SABIN JUMA
  • NPI Number: 1407862097
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2294067
LAB Type Pharmacy
Facility Name WALGREENS 00259
Street 3358 N WESTERN AVE
City CHICAGO
State IL
ZIP 60618
Phone 773 327-2111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Pharmacy
Lab Director SABIN JUMA

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