10D2215871 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2215871
  • Facility Name: WALGREEN CO
  • Facility Address: 9000 S US HWY 1
    PORT SAINT LUCIE, FL
    ZIP 34952
  • Facility Phone: 772 337-0112
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAGED A. KHODEIR
  • NPI Number: 1245247238
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2215871
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 9000 S US HWY 1
City PORT SAINT LUCIE
State FL
ZIP 34952
Phone 772 337-0112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director MAGED A. KHODEIR

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