18D2029819 CLIA NUMBER - WALGREENS #11761

Laboratory Demographics

CLIA Number: 18D2029819

Facility Name: WALGREENS #11761

Facility Address:
635 S DIXIE BLVD
RADCLIFF, KY
ZIP 40160
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Facility Phone Number: 270 352-0880

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1114187499

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 18D2029819
LAB Type Pharmacy
Facility Name WALGREENS #11761
Street 635 S DIXIE BLVD
City RADCLIFF
State KY
ZIP 40160
Phone 270 352-0880
CertificateType 4
CertificateEffectiveDate 3/8/2023
CertificateExpirationDate 3/7/2025
FacilityType Waiver

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