10D2039232 CLIA NUMBER - WALGREEN CO WALGREENS #5582

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Laboratory Demographics

CLIA Number: 10D2039232

Facility Name: WALGREEN CO WALGREENS #5582

Facility Address:
825 BEAL PKWY NW
FORT WALTON BEACH, FL
ZIP 32547
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Facility Phone Number: 850 314-0851

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1700891967

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	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
CertificateType	4
CertificateEffectiveDate	10/18/2023
CertificateExpirationDate	10/17/2025
FacilityType	Waiver

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