10D2012360 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012360
  • Facility Name: WALGREEN CO
  • Facility Address: 2075 US HWY 1 S
    SAINT AUGUSTINE, FL
    ZIP 32086
  • Facility Phone: 904 829-5240
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANTEL A. SMITH
  • NPI Number: 1134134331
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012360
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 2075 US HWY 1 S
City SAINT AUGUSTINE
State FL
ZIP 32086
Phone 904 829-5240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Pharmacy
Lab Director SHANTEL A. SMITH

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