40D2055773 CLIA NUMBER - WALGREENS SAN PATRICIO (ST 10160)

Laboratory Demographics

  • CLIA Code: 40D2055773
  • Facility Name: WALGREENS SAN PATRICIO (ST 10160)
  • Facility Address: 1 AVENIDA ROOSEVELT INTERSECCION ROOSEVELT AVE Y SAN PATRICIO AVENUE
    GUAYNABO, PR
    ZIP 00968
  • Facility Phone: 787 792-3725
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MRS. CHEILA FUMERO
  • NPI Number: 1124039359
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 40D2055773
LAB Type Pharmacy
Facility Name WALGREENS SAN PATRICIO (ST 10160)
Street 1 AVENIDA ROOSEVELT INTERSECCION ROOSEVELT AVE Y SAN PATRICIO AVENUE
City GUAYNABO
State PR
ZIP 00968
Phone 787 792-3725
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Pharmacy
Lab Director MRS. CHEILA FUMERO

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