10D2218701 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2218701
  • Facility Name: WALGREEN CO
  • Facility Address: 2405 MAYPORT RD
    ATLANTIC BEACH, FL
    ZIP 32233
  • Facility Phone: 904 435-0509
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUDREYOLE E. GILLIANS
  • NPI Number: 1598071904
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2218701
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 2405 MAYPORT RD
City ATLANTIC BEACH
State FL
ZIP 32233
Phone 904 435-0509
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Pharmacy
Lab Director AUDREYOLE E. GILLIANS

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