10D2013115 CLIA NUMBER - WALGREEN CO

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Laboratory Demographics

CLIA Number: 10D2013115

Facility Name: WALGREEN CO

Facility Address:
501 HAVENDALE BLVD
AUBURNDALE, FL
ZIP 33823
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Facility Phone Number: 863 967-7518

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1124033329

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	10D2013115
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	501 HAVENDALE BLVD
City	AUBURNDALE
State	FL
ZIP	33823
Phone	863 967-7518
CertificateType	4
CertificateEffectiveDate	11/30/2023
CertificateExpirationDate	11/29/2025
FacilityType	Waiver

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