18D2190550 CLIA NUMBER - WALGREENS #11664

Laboratory Demographics

  • CLIA Code: 18D2190550
  • Facility Name: WALGREENS #11664
  • Facility Address: 4926 CANE RUN ROAD
    LOUISVILLE, KY
    ZIP 40216
  • Facility Phone: 502 396-2296
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: MS. THIMIRA SUMANASEKERA
  • NPI Number: 1235652264
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2190550
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #11664
Street 4926 CANE RUN ROAD
City LOUISVILLE
State KY
ZIP 40216
Phone 502 396-2296
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director MS. THIMIRA SUMANASEKERA

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