10D2012377 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012377
  • Facility Name: WALGREEN CO
  • Facility Address: 7780 N WICKHAM RD
    MELBOURNE, FL
    ZIP 32940
  • Facility Phone: 321 254-1072
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BETHANY ONEAL
  • NPI Number: 1487669792
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012377
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 7780 N WICKHAM RD
City MELBOURNE
State FL
ZIP 32940
Phone 321 254-1072
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Pharmacy
Lab Director BETHANY ONEAL

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