10D2223724 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2223724
  • Facility Name: WALGREEN CO
  • Facility Address: 2475 US HIGHWAY 1
    MIMS, FL
    ZIP 32754
  • Facility Phone: 321 267-1788
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK GERSTLE
  • NPI Number: 1457534877
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2223724
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 2475 US HIGHWAY 1
City MIMS
State FL
ZIP 32754
Phone 321 267-1788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Pharmacy
Lab Director MARK GERSTLE

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