10D2216977 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2216977
  • Facility Name: WALGREEN CO
  • Facility Address: 1450 IMMOKALEE DR
    IMMOKALEE, FL
    ZIP 34142
  • Facility Phone: 239 658-2362
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABDELMOUGHIT HMISSA
  • NPI Number: 1538174792
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2216977
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1450 IMMOKALEE DR
City IMMOKALEE
State FL
ZIP 34142
Phone 239 658-2362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Pharmacy
Lab Director ABDELMOUGHIT HMISSA

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