18D2011100 CLIA NUMBER - WALGREENS #09524

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Laboratory Demographics

CLIA Number: 18D2011100

Facility Name: WALGREENS #09524

Facility Address:
10201 DIXIE HWY
LOUISVILLE, KY
ZIP 40272
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Facility Phone Number: 502 933-4003

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1942215181

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	18D2011100
LAB Type	Pharmacy
Facility Name	WALGREENS #09524
Street	10201 DIXIE HWY
City	LOUISVILLE
State	KY
ZIP	40272
Phone	502 933-4003
CertificateType	4
CertificateEffectiveDate	5/26/2023
CertificateExpirationDate	5/25/2025
FacilityType	Waiver

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