10D2051749 CLIA NUMBER - WALGREEN CO

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Laboratory Demographics

CLIA Number: 10D2051749

Facility Name: WALGREEN CO

Facility Address:
2991 ROOSEVELT BLVD
CLEARWATER, FL
ZIP 33760
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Facility Phone Number: 727 538-5660

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1366457541

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	10D2051749
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	2991 ROOSEVELT BLVD
City	CLEARWATER
State	FL
ZIP	33760
Phone	727 538-5660
CertificateType	4
CertificateEffectiveDate	7/30/2023
CertificateExpirationDate	7/29/2025
FacilityType	Waiver

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