10D2226192 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2226192

Facility Name: WALGREEN CO

Facility Address:
25091 S TAMIAMI TRAIL
BONITA SPRINGS, FL
ZIP 34134
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Facility Phone Number: 239 948-7532

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1679588008

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 10D2226192
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 25091 S TAMIAMI TRAIL
City BONITA SPRINGS
State FL
ZIP 34134
Phone 239 948-7532
CertificateType 4
CertificateEffectiveDate 5/27/2023
CertificateExpirationDate 5/26/2025
FacilityType Waiver

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