10D2061853 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2061853
  • Facility Name: WALGREEN CO
  • Facility Address: 103 S ORANGE AVE
    GREEN COVE SPRINGS, FL
    ZIP 32043
  • Facility Phone: 904 529-9156
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY H. PHAN
  • NPI Number: 1760609523
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2061853
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 103 S ORANGE AVE
City GREEN COVE SPRINGS
State FL
ZIP 32043
Phone 904 529-9156
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director AMY H. PHAN

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