10D2227177 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2227177
  • Facility Name: WALGREEN CO
  • Facility Address: 2592 S JENKINS RD
    FORT PIERCE, FL
    ZIP 34947
  • Facility Phone: 772 429-3174
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUNDEAP M. RAO
  • NPI Number: 1093960148
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2227177
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 2592 S JENKINS RD
City FORT PIERCE
State FL
ZIP 34947
Phone 772 429-3174
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Pharmacy
Lab Director SUNDEAP M. RAO

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