10D2224146 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2224146
  • Facility Name: WALGREEN CO
  • Facility Address: 1625 TAYLOR RD
    PORT ORANGE, FL
    ZIP 32128
  • Facility Phone: 386 761-5578
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAGED GIAD
  • NPI Number: 1710140066
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2224146
LAB Type Physician Office
Facility Name WALGREEN CO
Street 1625 TAYLOR RD
City PORT ORANGE
State FL
ZIP 32128
Phone 386 761-5578
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 Physician Office
Lab Director MAGED GIAD

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