10D2298153 CLIA NUMBER - WALGREEN CO

Laboratory Demographics

  • CLIA Code: 10D2298153
  • Facility Name: WALGREEN CO
  • Facility Address: 205 E GRANADA BLVD #00774
    ORMOND BEACH, FL
    ZIP 32176
  • Facility Phone: 386 677-8849
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD W. BOLT
  • NPI Number: 1487669651
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2298153
LAB Type Pharmacy
Facility Name WALGREEN CO
Street 205 E GRANADA BLVD #00774
City ORMOND BEACH
State FL
ZIP 32176
Phone 386 677-8849
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Pharmacy
Lab Director RICHARD W. BOLT

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