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18D2221845 CLIA NUMBER - WALGREENS #19765

Laboratory Demographics

CLIA Number: 18D2221845

Facility Name: WALGREENS #19765

Facility Address:
385 OLD GALLATIN RD
SCOTTSVILLE, KY
ZIP 42164
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Facility Phone Number: 270 237-3738

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043733173

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 18D2221845
LAB Type Pharmacy
Facility Name WALGREENS #19765
Street 385 OLD GALLATIN RD
City SCOTTSVILLE
State KY
ZIP 42164
Phone 270 237-3738
CertificateType 4
CertificateEffectiveDate 4/26/2023
CertificateExpirationDate 4/25/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024