10D2229418 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2229418

Facility Name: WALGREEN CO

Facility Address:
201 N HIATUS RD
PEMBROKE LAKES, FL
ZIP 33026
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Facility Phone Number: 954 431-4699

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1962683771

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	10D2229418
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	201 N HIATUS RD
City	PEMBROKE LAKES
State	FL
ZIP	33026
Phone	954 431-4699
CertificateType	4
CertificateEffectiveDate	7/12/2023
CertificateExpirationDate	7/11/2025
FacilityType	Waiver

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