10D2225579 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2225579

Facility Name: WALGREEN CO

Facility Address:
4451 W 12TH AVE
HIALEAH, FL
ZIP 33012
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Facility Phone Number: 305 556-8676

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1811902042

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	10D2225579
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	4451 W 12TH AVE
City	HIALEAH
State	FL
ZIP	33012
Phone	305 556-8676
CertificateType	4
CertificateEffectiveDate	5/21/2023
CertificateExpirationDate	5/20/2025
FacilityType	Waiver

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