18D2034721 CLIA NUMBER - WALGREENS #10507

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Laboratory Demographics

CLIA Number: 18D2034721

Facility Name: WALGREENS #10507

Facility Address:
807 S HIGHWAY 53
LA GRANGE, KY
ZIP 40031
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Facility Phone Number: 502 222-6550

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1407049828

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	18D2034721
LAB Type	Pharmacy
Facility Name	WALGREENS #10507
Street	807 S HIGHWAY 53
City	LA GRANGE
State	KY
ZIP	40031
Phone	502 222-6550
CertificateType	4
CertificateEffectiveDate	7/13/2023
CertificateExpirationDate	7/12/2025
FacilityType	Waiver

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