10D2062815 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2062815
  • Facility Name: WALGREEN CO
  • Facility Address: 205 W MADISON ST
    STARKE, FL
    ZIP 32091
  • Facility Phone: 904 964-2389
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY L. KAUFMAN
  • NPI Number: 1801931787
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2062815
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 205 W MADISON ST
City STARKE
State FL
ZIP 32091
Phone 904 964-2389
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Pharmacy
Lab Director KELLY L. KAUFMAN

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