10D2226717 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2226717
  • Facility Name: WALGREEN CO
  • Facility Address: 1954 SW GATLIN BLVD
    PORT SAINT LUCIE, FL
    ZIP 34953
  • Facility Phone: 772 224-3020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALMANDA A. HUME
  • NPI Number: 1255570404
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2226717
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 1954 SW GATLIN BLVD
City PORT SAINT LUCIE
State FL
ZIP 34953
Phone 772 224-3020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type Pharmacy
Lab Director ALMANDA A. HUME

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