10D2012330 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012330
  • Facility Name: WALGREEN CO
  • Facility Address: 1800 TAMIAMI TRL
    PORT CHARLOTTE, FL
    ZIP 33948
  • Facility Phone: 941 625-4847
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULIE R. GOMEZ
  • NPI Number: 1386659423
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012330
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1800 TAMIAMI TRL
City PORT CHARLOTTE
State FL
ZIP 33948
Phone 941 625-4847
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type Pharmacy
Lab Director JULIE R. GOMEZ

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