10D2225058 CLIA NUMBER - WALGREEN# 6928

Laboratory Demographics

  • CLIA Code: 10D2225058
  • Facility Name: WALGREEN# 6928
  • Facility Address: 609 KINGSLEY AVE
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 213-8083
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NAVIN MIDDELA
  • NPI Number: 1396752473
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2225058
LAB Type Pharmacy
Facility Name WALGREEN# 6928
Street 609 KINGSLEY AVE
City ORANGE PARK
State FL
ZIP 32073
Phone 904 213-8083
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 NAVIN MIDDELA

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