10D2012363 CLIA NUMBER - WALGREENS CO

Laboratory Demographics

  • CLIA Code: 10D2012363
  • Facility Name: WALGREENS CO
  • Facility Address: 1160 MALABAR RD SE
    PALM BAY, FL
    ZIP 32907
  • Facility Phone: 321 956-9626
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACEY R. HUMBERT
  • NPI Number: 1346255585
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012363
LAB Type Pharmacy
Facility Name WALGREENS CO
Street 1160 MALABAR RD SE
City PALM BAY
State FL
ZIP 32907
Phone 321 956-9626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Pharmacy
Lab Director TRACEY R. HUMBERT

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