18D2029805 CLIA NUMBER - WALGREENS #13034

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Laboratory Demographics

CLIA Number: 18D2029805

Facility Name: WALGREENS #13034

Facility Address:
528 WEST TENNESSEE AVE
PINEVILLE, KY
ZIP 40977
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Facility Phone Number: 606 337-1444

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1336397223

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	18D2029805
LAB Type	Pharmacy
Facility Name	WALGREENS #13034
Street	528 WEST TENNESSEE AVE
City	PINEVILLE
State	KY
ZIP	40977
Phone	606 337-1444
CertificateType	4
CertificateEffectiveDate	7/16/2023
CertificateExpirationDate	7/15/2025
FacilityType	Waiver

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