18D2022353 CLIA NUMBER - WALGREENS # 05449

Laboratory Demographics

  • CLIA Code: 18D2022353
  • Facility Name: WALGREENS # 05449
  • Facility Address: 3600 FERN VALLEY RD
    LOUISVILLE, KY
    ZIP 40219
  • Facility Phone: 502 964-7114
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHRISTOPHER FONG
  • NPI Number: 1851306096
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2022353
LAB Type Pharmacy
Facility Name WALGREENS # 05449
Street 3600 FERN VALLEY RD
City LOUISVILLE
State KY
ZIP 40219
Phone 502 964-7114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Pharmacy
Lab Director MR. CHRISTOPHER FONG

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