10D2040572 CLIA NUMBER - WALGREEN CO WALGREEN #6978

Laboratory Demographics

  • CLIA Code: 10D2040572
  • Facility Name: WALGREEN CO WALGREEN #6978
  • Facility Address: 4582 E HWY 20 WALGREEN #6978
    NICEVILLE, FL
    ZIP 32578
  • Facility Phone: 850 897-1368
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JODI L. VISI
  • NPI Number: 1457366635
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2040572
LAB Type Pharmacy
Facility Name WALGREEN CO WALGREEN #6978
Street 4582 E HWY 20 WALGREEN #6978
City NICEVILLE
State FL
ZIP 32578
Phone 850 897-1368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Pharmacy
Lab Director JODI L. VISI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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