18D2038736 CLIA NUMBER - WALGREENS # 12587

Laboratory Demographics

  • CLIA Code: 18D2038736
  • Facility Name: WALGREENS # 12587
  • Facility Address: 679 SOUTH MAIN ST
    MADISONVILLE, KY
    ZIP 42431
  • Facility Phone: 270 825-1541
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. TRAVIS PETERS
  • NPI Number: 1194966721
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2038736
LAB Type Pharmacy
Facility Name WALGREENS # 12587
Street 679 SOUTH MAIN ST
City MADISONVILLE
State KY
ZIP 42431
Phone 270 825-1541
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director MR. TRAVIS PETERS

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