10D2003197 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2003197
  • Facility Name: WALGREEN CO
  • Facility Address: 654 CASSAT AVE
    JACKSONVILLE, FL
    ZIP 32205
  • Facility Phone: 904 693-3321
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KERRYANN A. MCINTOSH
  • NPI Number: 1366458820
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2003197
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 654 CASSAT AVE
City JACKSONVILLE
State FL
ZIP 32205
Phone 904 693-3321
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Pharmacy
Lab Director KERRYANN A. MCINTOSH

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