10D2223988 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2223988

Facility Name: WALGREEN CO

Facility Address:
3090 NE 43RD AVE
HOMESTEAD, FL
ZIP 33033
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Facility Phone Number: 305 247-2549

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831106814

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	10D2223988
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	3090 NE 43RD AVE
City	HOMESTEAD
State	FL
ZIP	33033
Phone	305 247-2549
CertificateType	4
CertificateEffectiveDate	5/11/2023
CertificateExpirationDate	5/10/2025
FacilityType	Waiver

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