18D1089101 CLIA NUMBER - WALGREENS #07657

Laboratory Demographics

  • CLIA Code: 18D1089101
  • Facility Name: WALGREENS #07657
  • Facility Address: 2318 FREDERICA ST
    OWENSBORO, KY
    ZIP 42301
  • Facility Phone: 270 686-7873
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. ISLAM EROUK
  • NPI Number: 1124033378
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1089101
LAB Type Pharmacy
Facility Name WALGREENS #07657
Street 2318 FREDERICA ST
City OWENSBORO
State KY
ZIP 42301
Phone 270 686-7873
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director MR. ISLAM EROUK

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