14D2304663 CLIA NUMBER - OSCO DRUG #3453

Laboratory Demographics

  • CLIA Code: 14D2304663
  • Facility Name: OSCO DRUG #3453
  • Facility Address: 1350 S US HIGHWAY 12
    FOX LAKE, IL
    ZIP 60020
  • Facility Phone: 847 587-4206
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL T. RUSSELL
  • NPI Number: 1124074653
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2304663
LAB Type Pharmacy
Facility Name OSCO DRUG #3453
Street 1350 S US HIGHWAY 12
City FOX LAKE
State IL
ZIP 60020
Phone 847 587-4206
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Pharmacy
Lab Director RACHEL T. RUSSELL

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