10D2012436 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012436
  • Facility Name: WALGREEN CO
  • Facility Address: 12749 S CLEVELAND AVE
    FORT MYERS, FL
    ZIP 33907
  • Facility Phone: 239 939-2142
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATHNEAL G. MULUGETA
  • NPI Number: 1750392999
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012436
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 12749 S CLEVELAND AVE
City FORT MYERS
State FL
ZIP 33907
Phone 239 939-2142
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director NATHNEAL G. MULUGETA

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