10D2039232 CLIA NUMBER - WALGREEN CO WALGREENS #5582

Laboratory Demographics

  • CLIA Code: 10D2039232
  • Facility Name: WALGREEN CO WALGREENS #5582
  • Facility Address: 825 BEAL PKWY NW
    FORT WALTON BEACH, FL
    ZIP 32547
  • Facility Phone: 850 314-0851
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINH D. PHAN
  • NPI Number: 1700891967
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2039232
LAB Type Pharmacy
Facility Name WALGREEN CO WALGREENS #5582
Street 825 BEAL PKWY NW
City FORT WALTON BEACH
State FL
ZIP 32547
Phone 850 314-0851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Pharmacy
Lab Director LINH D. PHAN

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