10D2288441 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2288441

Facility Name: WALGREEN CO

Facility Address:
2679 N ATLANTIC AVE
DAYTONA BEACH, FL
ZIP 32118
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Facility Phone Number: 386 672-2008

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1023023207

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	10D2288441
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	2679 N ATLANTIC AVE
City	DAYTONA BEACH
State	FL
ZIP	32118
Phone	386 672-2008
CertificateType	4
CertificateEffectiveDate	8/25/2023
CertificateExpirationDate	8/24/2025
FacilityType	Waiver

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