10D2012363 CLIA NUMBER - WALGREENS CO

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Laboratory Demographics

CLIA Number: 10D2012363

Facility Name: WALGREENS CO

Facility Address:
1160 MALABAR RD SE
PALM BAY, FL
ZIP 32907
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Facility Phone Number: 321 956-9626

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1346255585

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType	4
CertificateEffectiveDate	6/2/2023
CertificateExpirationDate	6/1/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024