10D2012416 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012416
  • Facility Name: WALGREEN CO
  • Facility Address: 113 MAITLAND AVE
    ALTAMONTE SPRINGS, FL
    ZIP 32701
  • Facility Phone: 407 331-4698
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDRIA N. BENNETT
  • NPI Number: 1104831395
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012416
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 113 MAITLAND AVE
City ALTAMONTE SPRINGS
State FL
ZIP 32701
Phone 407 331-4698
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director ALEXANDRIA N. BENNETT

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