10D1089726 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D1089726

Facility Name: WALGREEN CO

Facility Address:
1800 W INDIANTOWN RD
JUPITER, FL
ZIP 33458
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Facility Phone Number: 561 744-6822

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1396752382

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	10D1089726
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	1800 W INDIANTOWN RD
City	JUPITER
State	FL
ZIP	33458
Phone	561 744-6822
CertificateType	4
CertificateEffectiveDate	5/17/2023
CertificateExpirationDate	5/16/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024