18D2026655 CLIA NUMBER - WALGREENS # 06443

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Laboratory Demographics

CLIA Number: 18D2026655

Facility Name: WALGREENS # 06443

Facility Address:
990 BAXTER AVE
LOUISVILLE, KY
ZIP 40204
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Facility Phone Number: 502 585-3239

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1043225279

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	18D2026655
LAB Type	Pharmacy
Facility Name	WALGREENS # 06443
Street	990 BAXTER AVE
City	LOUISVILLE
State	KY
ZIP	40204
Phone	502 585-3239
CertificateType	4
CertificateEffectiveDate	5/26/2023
CertificateExpirationDate	5/25/2025
FacilityType	Waiver

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