10D2216283 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2216283
  • Facility Name: WALGREEN CO
  • Facility Address: 4105 POINTE PLAZA BLVD
    VENICE, FL
    ZIP 34293
  • Facility Phone: 941 497-0751
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAFAEL OLAVARRIA RODRIGUEZ
  • NPI Number: 1477568517
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2216283
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 4105 POINTE PLAZA BLVD
City VENICE
State FL
ZIP 34293
Phone 941 497-0751
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 RAFAEL OLAVARRIA RODRIGUEZ

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