10D2013159 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2013159
  • Facility Name: WALGREEN CO
  • Facility Address: 11115 E DR MARTIN LUTHER KING JR BLVD
    SEFFNER, FL
    ZIP 33584
  • Facility Phone: 813 689-4049
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIN A. STIP
  • NPI Number: 1699780700
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2013159
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 11115 E DR MARTIN LUTHER KING JR BLVD
City SEFFNER
State FL
ZIP 33584
Phone 813 689-4049
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Pharmacy
Lab Director KRISTIN A. STIP

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