10D2216282 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2216282
  • Facility Name: WALGREEN CO
  • Facility Address: 52 E PALM DR
    FLORIDA CITY, FL
    ZIP 33034
  • Facility Phone: 305 248-8197
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SASHA GOUSSE
  • NPI Number: 1740425289
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2216282
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 52 E PALM DR
City FLORIDA CITY
State FL
ZIP 33034
Phone 305 248-8197
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 SASHA GOUSSE

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