10D2216276 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2216276

Facility Name: WALGREEN CO

Facility Address:
11494 BONITA BEACH RD SE
BONITA SPRINGS, FL
ZIP 34135
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Facility Phone Number: 239 992-3894

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1689689879

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	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
CertificateType	4
CertificateEffectiveDate	3/11/2023
CertificateExpirationDate	3/10/2025
FacilityType	Waiver

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