10D2033017 CLIA NUMBER - WALGREEN CO

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Laboratory Demographics

CLIA Number: 10D2033017

Facility Name: WALGREEN CO

Facility Address:
5709 GUNN HWY
TAMPA, FL
ZIP 33615
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Facility Phone Number: 813 969-4203

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831104140

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	10D2033017
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	5709 GUNN HWY
City	TAMPA
State	FL
ZIP	33615
Phone	813 969-4203
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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