10D2289520 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

CLIA Number: 10D2289520

Facility Name: WALGREEN CO

Facility Address:
13316 HARTZOG RD
WINTER GARDEN, FL
ZIP 34787
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Facility Phone Number: 321 329-3546

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1679246672

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	10D2289520
LAB Type	Pharmacy
Facility Name	WALGREEN CO
Street	13316 HARTZOG RD
City	WINTER GARDEN
State	FL
ZIP	34787
Phone	321 329-3546
CertificateType	4
CertificateEffectiveDate	9/12/2023
CertificateExpirationDate	9/11/2025
FacilityType	Waiver

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