18D2038640 CLIA NUMBER - WALGREENS #12111

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Laboratory Demographics

CLIA Number: 18D2038640

Facility Name: WALGREENS #12111

Facility Address:
14659 N US HWY 25 E
CORBIN, KY
ZIP 40701
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Facility Phone Number: 606 258-7980

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871721712

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	18D2038640
LAB Type	Pharmacy
Facility Name	WALGREENS #12111
Street	14659 N US HWY 25 E
City	CORBIN
State	KY
ZIP	40701
Phone	606 258-7980
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