10D2012358 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012358
  • Facility Name: WALGREEN CO
  • Facility Address: 1111 W VINE STREET
    KISSIMMEE, FL
    ZIP 34741
  • Facility Phone: 407 847-5252
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FARHANA AKTER
  • NPI Number: 1215944293
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012358
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1111 W VINE STREET
City KISSIMMEE
State FL
ZIP 34741
Phone 407 847-5252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Pharmacy
Lab Director FARHANA AKTER

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This page was last updated on: 6/4/2025