18D2041772 CLIA NUMBER - WALGREENS #11796

Laboratory Demographics

  • CLIA Code: 18D2041772
  • Facility Name: WALGREENS #11796
  • Facility Address: 220 RICHMOND RD N
    BEREA, KY
    ZIP 40403
  • Facility Phone: 859 986-1494
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. JILLIANNE L. HILLER
  • NPI Number: 1235386541
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2041772
LAB Type Pharmacy
Facility Name WALGREENS #11796
Street 220 RICHMOND RD N
City BEREA
State KY
ZIP 40403
Phone 859 986-1494
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Pharmacy
Lab Director MS. JILLIANNE L. HILLER

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This page was last updated on: 6/4/2025