18D2011197 CLIA NUMBER - WALGREENS #07925

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Laboratory Demographics

CLIA Number: 18D2011197

Facility Name: WALGREENS #07925

Facility Address:
402 2ND STREET
HENDERSON, KY
ZIP 42420
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Facility Phone Number: 270 830-6502

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1457453714

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	18D2011197
LAB Type	Pharmacy
Facility Name	WALGREENS #07925
Street	402 2ND STREET
City	HENDERSON
State	KY
ZIP	42420
Phone	270 830-6502
CertificateType	4
CertificateEffectiveDate	1/25/2024
CertificateExpirationDate	1/24/2026
FacilityType	Waiver

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