10D2216376 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2216376
  • Facility Name: WALGREEN CO
  • Facility Address: 3890 VAN DYKE RD
    LUTZ, FL
    ZIP 33548
  • Facility Phone: 813 269-2814
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY PEARSON
  • NPI Number: 1942215132
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2216376
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 3890 VAN DYKE RD
City LUTZ
State FL
ZIP 33548
Phone 813 269-2814
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 KIMBERLY PEARSON

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This page was last updated on: 3/20/2025