10D2020884 CLIA NUMBER - WALGREEN CO

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Laboratory Demographics

CLIA Number: 10D2020884

Facility Name: WALGREEN CO

Facility Address:
30280 US HWY 19 N
CLEARWATER, FL
ZIP 33761
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Facility Phone Number: 727 282-1003

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1629379862

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	10D2020884
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	30280 US HWY 19 N
City	CLEARWATER
State	FL
ZIP	33761
Phone	727 282-1003
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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