10D2012588 CLIA NUMBER - WALGREEN CO

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Laboratory Demographics

CLIA Number: 10D2012588

Facility Name: WALGREEN CO

Facility Address:
340 SW 24TH ST
FORT LAUDERDALE, FL
ZIP 33315
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Facility Phone Number: 954 764-1584

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1417962762

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	10D2012588
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	340 SW 24TH ST
City	FORT LAUDERDALE
State	FL
ZIP	33315
Phone	954 764-1584
CertificateType	4
CertificateEffectiveDate	5/18/2023
CertificateExpirationDate	5/17/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024