10D2243368 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2243368
  • Facility Name: WALGREEN CO
  • Facility Address: 410 OLD POLK CITY RD
    LAKELAND, FL
    ZIP 33809
  • Facility Phone: 863 815-3373
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE E. ODOM
  • NPI Number: 1588671663
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2243368
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 410 OLD POLK CITY RD
City LAKELAND
State FL
ZIP 33809
Phone 863 815-3373
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Pharmacy
Lab Director NICOLE E. ODOM

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