10D2221424 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2221424
  • Facility Name: WALGREEN CO
  • Facility Address: 1515 OHIO AVE S
    LIVE OAK, FL
    ZIP 32064
  • Facility Phone: 386 330-2766
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REBECCA SAPP
  • NPI Number: 1154357655
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2221424
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1515 OHIO AVE S
City LIVE OAK
State FL
ZIP 32064
Phone 386 330-2766
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Pharmacy
Lab Director REBECCA SAPP

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