18D2038628 CLIA NUMBER - WALGREENS 09712

Laboratory Demographics

  • CLIA Code: 18D2038628
  • Facility Name: WALGREENS 09712
  • Facility Address: 901 N MAIN STREET
    NICHOLASVILLE, KY
    ZIP 40356
  • Facility Phone: 859 881-8203
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. BRYAN CAMPBELL
  • NPI Number: 1023164449
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2038628
LAB Type Pharmacy
Facility Name WALGREENS 09712
Street 901 N MAIN STREET
City NICHOLASVILLE
State KY
ZIP 40356
Phone 859 881-8203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Pharmacy
Lab Director MR. BRYAN CAMPBELL

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