10D2012357 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012357
  • Facility Name: WALGREEN CO
  • Facility Address: 790 W GRANADA BLVD
    ORMOND BEACH, FL
    ZIP 32174
  • Facility Phone: 386 672-7107
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBRA A. STINSON
  • NPI Number: 1487669602
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012357
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 790 W GRANADA BLVD
City ORMOND BEACH
State FL
ZIP 32174
Phone 386 672-7107
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 DEBRA A. STINSON

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