10D1085717 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D1085717
  • Facility Name: WALGREEN CO
  • Facility Address: 3053 SW MARTIN DOWNS BLVD
    PALM CITY, FL
    ZIP 34990
  • Facility Phone: 772 288-0105
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT P. RANTINELLA
  • NPI Number: 1518972629
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D1085717
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 3053 SW MARTIN DOWNS BLVD
City PALM CITY
State FL
ZIP 34990
Phone 772 288-0105
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Pharmacy
Lab Director ROBERT P. RANTINELLA

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