10D2013110 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2013110
  • Facility Name: WALGREEN CO
  • Facility Address: 1903 STATE RD 60 E
    LAKE WALES, FL
    ZIP 33853
  • Facility Phone: 863 676-9496
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRATIK G. PATEL
  • NPI Number: 1164437273
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2013110
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1903 STATE RD 60 E
City LAKE WALES
State FL
ZIP 33853
Phone 863 676-9496
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Pharmacy
Lab Director PRATIK G. PATEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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