18D2038634 CLIA NUMBER - WALGREENS #11884

Laboratory Demographics

  • CLIA Code: 18D2038634
  • Facility Name: WALGREENS #11884
  • Facility Address: 1121 SOUTH US HIGHWAY 25E
    BARBOURVILLE, KY
    ZIP 40906
  • Facility Phone: 606 545-7314
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. THOMAS W. GOODIN
  • NPI Number: 1346498698
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2038634
LAB Type Pharmacy
Facility Name WALGREENS #11884
Street 1121 SOUTH US HIGHWAY 25E
City BARBOURVILLE
State KY
ZIP 40906
Phone 606 545-7314
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director MR. THOMAS W. GOODIN

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