10D2221007 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2221007

Facility Name: WALGREEN CO

Facility Address:
5903 S ORANGE BLOSSOM TRAIL
ORLANDO, FL
ZIP 32809
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Facility Phone Number: 407 240-6199

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205011673

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	10D2221007
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	5903 S ORANGE BLOSSOM TRAIL
City	ORLANDO
State	FL
ZIP	32809
Phone	407 240-6199
CertificateType	4
CertificateEffectiveDate	4/16/2023
CertificateExpirationDate	4/15/2025
FacilityType	Waiver

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