18D2038641 CLIA NUMBER - WALGREENS #12152

Laboratory Demographics

  • CLIA Code: 18D2038641
  • Facility Name: WALGREENS #12152
  • Facility Address: 1775 HIGHWAY 192 W
    LONDON, KY
    ZIP 40741
  • Facility Phone: 606 877-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JARED S. MASTERS
  • NPI Number: 1760646079
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2038641
LAB Type Pharmacy
Facility Name WALGREENS #12152
Street 1775 HIGHWAY 192 W
City LONDON
State KY
ZIP 40741
Phone 606 877-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Pharmacy
Lab Director MR. JARED S. MASTERS

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