10D2224266 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2224266

Facility Name: WALGREEN CO

Facility Address:
2415 SW 75TH ST
GAINESVILLE, FL
ZIP 32608
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Facility Phone Number: 352 333-9704

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1700891959

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	10D2224266
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	2415 SW 75TH ST
City	GAINESVILLE
State	FL
ZIP	32608
Phone	352 333-9704
CertificateType	4
CertificateEffectiveDate	5/12/2023
CertificateExpirationDate	5/11/2025
FacilityType	Waiver

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