10D2013154 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2013154
  • Facility Name: WALGREEN CO
  • Facility Address: 1860 E FOWLER AVE
    TAMPA, FL
    ZIP 33612
  • Facility Phone: 813 977-0651
  • Facility Type: Other - COVID 19 TESTING SITE
  • Facility Type: Waiver
  • Lab Director: SHANNY LEE
  • NPI Number: 1598771180
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2013154
LAB Type Other - COVID 19 TESTING SITE
Facility Name WALGREEN CO
Street 1860 E FOWLER AVE
City TAMPA
State FL
ZIP 33612
Phone 813 977-0651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Other - COVID 19 TESTING SITE
Lab Director SHANNY LEE

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