10D2012581 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2012581
  • Facility Name: WALGREEN CO
  • Facility Address: 2480 US HIGHWAY 19
    HOLIDAY, FL
    ZIP 34691
  • Facility Phone: 727 937-3247
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMARA A. DESIDERIO
  • NPI Number: 1063427276
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012581
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 2480 US HIGHWAY 19
City HOLIDAY
State FL
ZIP 34691
Phone 727 937-3247
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Pharmacy
Lab Director TAMARA A. DESIDERIO

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