10D2232029 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2232029
  • Facility Name: WALGREEN CO
  • Facility Address: 4204 PALM BEACH RD
    FORT MYERS, FL
    ZIP 33905
  • Facility Phone: 239 694-2114
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FADY S. YASSA
  • NPI Number: 1740295963
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2232029
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 4204 PALM BEACH RD
City FORT MYERS
State FL
ZIP 33905
Phone 239 694-2114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director FADY S. YASSA

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