18D2038728 CLIA NUMBER - WALGREEN # 12090

Laboratory Demographics

  • CLIA Code: 18D2038728
  • Facility Name: WALGREEN # 12090
  • Facility Address: 635 S 6TH STREET
    MAYFIELD, KY
    ZIP 42066
  • Facility Phone: 270 247-2272
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. JULIE HAGAN
  • NPI Number: 1831323914
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2038728
LAB Type Pharmacy
Facility Name WALGREEN # 12090
Street 635 S 6TH STREET
City MAYFIELD
State KY
ZIP 42066
Phone 270 247-2272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Pharmacy
Lab Director MS. JULIE HAGAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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