18D2026655 CLIA NUMBER - WALGREENS # 06443

Laboratory Demographics

  • CLIA Code: 18D2026655
  • Facility Name: WALGREENS # 06443
  • Facility Address: 990 BAXTER AVE
    LOUISVILLE, KY
    ZIP 40204
  • Facility Phone: 502 585-3239
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. AMANUEL NIGUSSE
  • NPI Number: 1043225279
  • Taxonomy: 333600000X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director MR. AMANUEL NIGUSSE

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