10D2225817 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2225817
  • Facility Name: WALGREEN CO
  • Facility Address: 4210 E STATE ROAD 64
    BRADENTON, FL
    ZIP 34208
  • Facility Phone: 941 708-9161
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GIAU T. LE
  • NPI Number: 1609881846
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2225817
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 4210 E STATE ROAD 64
City BRADENTON
State FL
ZIP 34208
Phone 941 708-9161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director GIAU T. LE

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