14D2296162 CLIA NUMBER - WALGREENS 02585

Laboratory Demographics

  • CLIA Code: 14D2296162
  • Facility Name: WALGREENS 02585
  • Facility Address: 3808 AUBURN ST
    ROCKFORD, IL
    ZIP 61101
  • Facility Phone: 815 963-3705
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVEN E. KOEPSELL
  • NPI Number: 1699780841
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2296162
LAB Type Pharmacy
Facility Name WALGREENS 02585
Street 3808 AUBURN ST
City ROCKFORD
State IL
ZIP 61101
Phone 815 963-3705
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2023
Certificate Expiration Date 12/20/2025
Facility Type Pharmacy
Lab Director STEVEN E. KOEPSELL

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