10D2040856 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2040856
  • Facility Name: WALGREEN CO
  • Facility Address: 34909 EMERALD COAST PKWY
    DESTIN, FL
    ZIP 32541
  • Facility Phone: 850 654-7291
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERICA RATANOTHAYANON
  • NPI Number: 1265447403
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2040856
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 34909 EMERALD COAST PKWY
City DESTIN
State FL
ZIP 32541
Phone 850 654-7291
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Pharmacy
Lab Director ERICA RATANOTHAYANON

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