40D2223102 CLIA NUMBER - WALGREENS # 12651

Laboratory Demographics

  • CLIA Code: 40D2223102
  • Facility Name: WALGREENS # 12651
  • Facility Address: CARR 165, KM 47, BO QUEBRADA CRUZ PLAZA AQUARIUM
    TOA ALTA, PR
    ZIP 00954
  • Facility Phone: 787 705-6555
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CELINES RODRIGUEZ
  • NPI Number: 1760655021
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 40D2223102
LAB Type Pharmacy
Facility Name WALGREENS # 12651
Street CARR 165, KM 47, BO QUEBRADA CRUZ PLAZA AQUARIUM
City TOA ALTA
State PR
ZIP 00954
Phone 787 705-6555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director CELINES RODRIGUEZ

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This page was last updated on: 6/4/2025