10D2033017 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2033017
  • Facility Name: WALGREEN CO
  • Facility Address: 5709 GUNN HWY
    TAMPA, FL
    ZIP 33615
  • Facility Phone: 813 969-4203
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VISHAL B. MODI
  • NPI Number: 1831104140
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2033017
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 5709 GUNN HWY
City TAMPA
State FL
ZIP 33615
Phone 813 969-4203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Pharmacy
Lab Director VISHAL B. MODI

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