10D2288539 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2288539

Facility Name: WALGREEN CO

Facility Address:
3799 MURRELL RD
ROCKLEDGE, FL
ZIP 32955
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Facility Phone Number: 321 631-2755

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1336156413

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	10D2288539
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	3799 MURRELL RD
City	ROCKLEDGE
State	FL
ZIP	32955
Phone	321 631-2755
CertificateType	4
CertificateEffectiveDate	8/28/2023
CertificateExpirationDate	8/27/2025
FacilityType	Waiver

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