18D2011100 CLIA NUMBER - WALGREENS #09524

Laboratory Demographics

  • CLIA Code: 18D2011100
  • Facility Name: WALGREENS #09524
  • Facility Address: 10201 DIXIE HWY
    LOUISVILLE, KY
    ZIP 40272
  • Facility Phone: 502 933-4003
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. DANE E. FAJACK
  • NPI Number: 1942215181
  • Taxonomy: 333600000X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director MR. DANE E. FAJACK

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