10D2011910 CLIA NUMBER - WALGREENS #04693

Laboratory Demographics

  • CLIA Code: 10D2011910
  • Facility Name: WALGREENS #04693
  • Facility Address: 4601 N STATE RD 7
    COCONUT CREEK, FL
    ZIP 33073
  • Facility Phone: 954 345-4456
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY M. KUPIEC
  • NPI Number: 1437164670
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2011910
LAB Type Pharmacy
Facility Name WALGREENS #04693
Street 4601 N STATE RD 7
City COCONUT CREEK
State FL
ZIP 33073
Phone 954 345-4456
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Pharmacy
Lab Director JEFFREY M. KUPIEC

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