10D2224130 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2224130
  • Facility Name: WALGREEN CO
  • Facility Address: 1120 TAMIAMI TRL N
    NOKOMIS, FL
    ZIP 34275
  • Facility Phone: 941 441-2909
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SIVILAY KEOVILAY
  • NPI Number: 1467764365
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2224130
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1120 TAMIAMI TRL N
City NOKOMIS
State FL
ZIP 34275
Phone 941 441-2909
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director SIVILAY KEOVILAY

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