10D2013124 CLIA NUMBER - WALGREENS #04569

Laboratory Demographics

  • CLIA Code: 10D2013124
  • Facility Name: WALGREENS #04569
  • Facility Address: 3895 W BROWARD BLVD
    PLANTATION, FL
    ZIP 33312
  • Facility Phone: 954 316-6641
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KUNAL PATEL
  • NPI Number: 1457367914
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2013124
LAB Type Pharmacy
Facility Name WALGREENS #04569
Street 3895 W BROWARD BLVD
City PLANTATION
State FL
ZIP 33312
Phone 954 316-6641
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Pharmacy
Lab Director KUNAL PATEL

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