10D2036392 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2036392
  • Facility Name: WALGREEN CO
  • Facility Address: 1213 PALM BAY RD
    MELBOURNE, FL
    ZIP 32905
  • Facility Phone: 321 676-4602
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DENIQUE REDDIE
  • NPI Number: 1336156314
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2036392
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1213 PALM BAY RD
City MELBOURNE
State FL
ZIP 32905
Phone 321 676-4602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Pharmacy
Lab Director DENIQUE REDDIE

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