10D2225047 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2225047
  • Facility Name: WALGREEN CO
  • Facility Address: 8917 SAN JOSE BLVD
    JACKSONVILLE, FL
    ZIP 32257
  • Facility Phone: 904 636-8186
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANSEL AVILA
  • NPI Number: 1780691774
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2225047
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 8917 SAN JOSE BLVD
City JACKSONVILLE
State FL
ZIP 32257
Phone 904 636-8186
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Pharmacy
Lab Director ANSEL AVILA

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