10D2223184 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2223184
  • Facility Name: WALGREEN CO
  • Facility Address: 116 BLACKFORD WAY
    ST AUGUSTINE, FL
    ZIP 32086
  • Facility Phone: 904 436-0006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SRILATHA ANUMASU
  • NPI Number: 1447567235
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2223184
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 116 BLACKFORD WAY
City ST AUGUSTINE
State FL
ZIP 32086
Phone 904 436-0006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director SRILATHA ANUMASU

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