10D2012457 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012457
  • Facility Name: WALGREEN CO
  • Facility Address: 5800 SE FEDERAL HWY
    STUART, FL
    ZIP 34997
  • Facility Phone: 772 286-0551
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CLEVENS M. JEROME
  • NPI Number: 1972518181
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012457
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 5800 SE FEDERAL HWY
City STUART
State FL
ZIP 34997
Phone 772 286-0551
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director CLEVENS M. JEROME

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