10D2011996 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2011996
  • Facility Name: WALGREEN CO
  • Facility Address: 1320 BLANDING BLVD
    ORANGE PARK, FL
    ZIP 32065
  • Facility Phone: 904 276-6434
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SOPHAN LIM
  • NPI Number: 1801801030
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2011996
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1320 BLANDING BLVD
City ORANGE PARK
State FL
ZIP 32065
Phone 904 276-6434
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 SOPHAN LIM

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