10D2218717 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2218717

Facility Name: WALGREEN CO

Facility Address:
101 W ARDICE AVE
EUSTIS, FL
ZIP 32726
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Facility Phone Number: 352 589-5062

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1659387033

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	10D2218717
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	101 W ARDICE AVE
City	EUSTIS
State	FL
ZIP	32726
Phone	352 589-5062
CertificateType	4
CertificateEffectiveDate	3/30/2023
CertificateExpirationDate	3/29/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024