10D2012417 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012417
  • Facility Name: WALGREEN CO
  • Facility Address: 4150 N ATLANTIC AVE
    COCOA BEACH, FL
    ZIP 32931
  • Facility Phone: 321 799-9112
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANH T. PHAN
  • NPI Number: 1003821141
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012417
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 4150 N ATLANTIC AVE
City COCOA BEACH
State FL
ZIP 32931
Phone 321 799-9112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2025
Certificate Expiration Date 5/26/2027
Facility Type Pharmacy
Lab Director ANH T. PHAN

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