10D2057260 CLIA NUMBER - WALGREEN CO

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Laboratory Demographics

CLIA Number: 10D2057260

Facility Name: WALGREEN CO

Facility Address:
115 N LAWRENCE BLVD
KEYSTONE HEIGHTS, FL
ZIP 32656
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Facility Phone Number: 352 473-4621

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1841205036

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	10D2057260
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	115 N LAWRENCE BLVD
City	KEYSTONE HEIGHTS
State	FL
ZIP	32656
Phone	352 473-4621
CertificateType	4
CertificateEffectiveDate	7/29/2023
CertificateExpirationDate	7/28/2025
FacilityType	Waiver

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