18D2023538 CLIA NUMBER - WALGREENS #15183

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Laboratory Demographics

CLIA Number: 18D2023538

Facility Name: WALGREENS #15183

Facility Address:
3410 W BROADWAY
LOUISVILLE, KY
ZIP 40211
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Facility Phone Number: 502 776-2528

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1396750535

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	18D2023538
LAB Type	Pharmacy
Facility Name	WALGREENS #15183
Street	3410 W BROADWAY
City	LOUISVILLE
State	KY
ZIP	40211
Phone	502 776-2528
CertificateType	4
CertificateEffectiveDate	4/10/2023
CertificateExpirationDate	4/9/2025
FacilityType	Waiver

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