10D2013715 CLIA NUMBER - WALGREENS #04324

Laboratory Demographics

  • CLIA Code: 10D2013715
  • Facility Name: WALGREENS #04324
  • Facility Address: 15911 PINES BLVD
    PEMBROKE PINES, FL
    ZIP 33027
  • Facility Phone: 954 450-8896
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASRESU H. MEKONNEN
  • NPI Number: 1265448708
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2013715
LAB Type Pharmacy
Facility Name WALGREENS #04324
Street 15911 PINES BLVD
City PEMBROKE PINES
State FL
ZIP 33027
Phone 954 450-8896
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Pharmacy
Lab Director ASRESU H. MEKONNEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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