10D2012326 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012326
  • Facility Name: WALGREEN CO
  • Facility Address: 100 E INTERNATIONAL SPEEDWAY BLVD
    DELAND, FL
    ZIP 32724
  • Facility Phone: 386 738-4371
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LATRELLE A. FAKEYE
  • NPI Number: 1972518082
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012326
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 100 E INTERNATIONAL SPEEDWAY BLVD
City DELAND
State FL
ZIP 32724
Phone 386 738-4371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Pharmacy
Lab Director LATRELLE A. FAKEYE

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