10D2012242 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012242
  • Facility Name: WALGREEN CO
  • Facility Address: 860 A1A N
    PONTE VEDRA BEACH, FL
    ZIP 32082
  • Facility Phone: 904 543-0762
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KARI OBERC
  • NPI Number: 1356356588
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012242
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 860 A1A N
City PONTE VEDRA BEACH
State FL
ZIP 32082
Phone 904 543-0762
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Pharmacy
Lab Director KARI OBERC

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