10D2013256 CLIA NUMBER - WALGREEN CO

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Laboratory Demographics

CLIA Number: 10D2013256

Facility Name: WALGREEN CO

Facility Address:
17511 BRUCE B DOWNS BLVD
TAMPA, FL
ZIP 33647
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Facility Phone Number: 813 903-8404

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1619982865

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	10D2013256
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	17511 BRUCE B DOWNS BLVD
City	TAMPA
State	FL
ZIP	33647
Phone	813 903-8404
CertificateType	4
CertificateEffectiveDate	8/25/2023
CertificateExpirationDate	8/24/2025
FacilityType	Waiver

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