18D2218350 CLIA NUMBER - WALGREENS #19971

Laboratory Demographics

  • CLIA Code: 18D2218350
  • Facility Name: WALGREENS #19971
  • Facility Address: 100 S CAROL MALONE BLVD
    GRAYSON, KY
    ZIP 41143
  • Facility Phone: 606 474-4470
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. JILLIANNE L. HILLER
  • NPI Number: 1588187926
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2218350
LAB Type Pharmacy
Facility Name WALGREENS #19971
Street 100 S CAROL MALONE BLVD
City GRAYSON
State KY
ZIP 41143
Phone 606 474-4470
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director MS. JILLIANNE L. HILLER

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