10D2051750 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2051750
  • Facility Name: WALGREEN CO
  • Facility Address: 3909 HWY 90
    PACE, FL
    ZIP 32571
  • Facility Phone: 850 994-1363
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACY L. JUDGE
  • NPI Number: 1376558544
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2051750
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 3909 HWY 90
City PACE
State FL
ZIP 32571
Phone 850 994-1363
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 TRACY L. JUDGE

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