10D2040044 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2040044
  • Facility Name: WALGREEN CO
  • Facility Address: 414 C MARY ESTHER CUT OFF NW
    FORT WALTON BEACH, FL
    ZIP 32548
  • Facility Phone: 850 244-0869
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CLARENCE ANSLEY
  • NPI Number: 1619982857
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2040044
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 414 C MARY ESTHER CUT OFF NW
City FORT WALTON BEACH
State FL
ZIP 32548
Phone 850 244-0869
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type Pharmacy
Lab Director CLARENCE ANSLEY

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