10D2216276 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2216276
  • Facility Name: WALGREEN CO
  • Facility Address: 11494 BONITA BEACH RD SE
    BONITA SPRINGS, FL
    ZIP 34135
  • Facility Phone: 239 992-3894
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PETER J. RISO
  • NPI Number: 1689689879
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2216276
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 11494 BONITA BEACH RD SE
City BONITA SPRINGS
State FL
ZIP 34135
Phone 239 992-3894
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Pharmacy
Lab Director PETER J. RISO

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