18D2021858 CLIA NUMBER - WALGREENS # 04309

Laboratory Demographics

  • CLIA Code: 18D2021858
  • Facility Name: WALGREENS # 04309
  • Facility Address: 9702 WESTPORT RD
    LOUISVILLE, KY
    ZIP 40241
  • Facility Phone: 502 425-1434
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHRISTOPHER MACK
  • NPI Number: 1780699934
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2021858
LAB Type Pharmacy
Facility Name WALGREENS # 04309
Street 9702 WESTPORT RD
City LOUISVILLE
State KY
ZIP 40241
Phone 502 425-1434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Pharmacy
Lab Director MR. CHRISTOPHER MACK

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