10D2223785 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2223785
  • Facility Name: WALGREEN CO
  • Facility Address: 40079 HIGHWAY 27
    DAVENPORT, FL
    ZIP 33837
  • Facility Phone: 863 547-3903
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ORADY SENAMOONTRY
  • NPI Number: 1104127349
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2223785
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 40079 HIGHWAY 27
City DAVENPORT
State FL
ZIP 33837
Phone 863 547-3903
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 ORADY SENAMOONTRY

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