18D2011197 CLIA NUMBER - WALGREENS #07925

Laboratory Demographics

  • CLIA Code: 18D2011197
  • Facility Name: WALGREENS #07925
  • Facility Address: 402 2ND STREET
    HENDERSON, KY
    ZIP 42420
  • Facility Phone: 270 830-6502
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. MONALISA F. MAKETIWA
  • NPI Number: 1457453714
  • Taxonomy: 333600000X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Pharmacy
Lab Director MS. MONALISA F. MAKETIWA

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