10D2230252 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2230252
  • Facility Name: WALGREEN CO
  • Facility Address: 280 SW PORT ST LUCIE
    PORT SAINT LUCIE, FL
    ZIP 34984
  • Facility Phone: 772 878-6353
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS K. LOHSE
  • NPI Number: 1720093958
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2230252
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 280 SW PORT ST LUCIE
City PORT SAINT LUCIE
State FL
ZIP 34984
Phone 772 878-6353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Pharmacy
Lab Director NICHOLAS K. LOHSE

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