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18D2229471 CLIA NUMBER - WALGREENS #17478

Laboratory Demographics

CLIA Number: 18D2229471

Facility Name: WALGREENS #17478

Facility Address:
415 NORTH LINCOLN BOULEVARD
HODGENVILLE, KY
ZIP 42748
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Facility Phone Number: 270 358-3186

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1174046437

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 18D2229471
LAB Type Pharmacy
Facility Name WALGREENS #17478
Street 415 NORTH LINCOLN BOULEVARD
City HODGENVILLE
State KY
ZIP 42748
Phone 270 358-3186
CertificateType 4
CertificateEffectiveDate 7/13/2023
CertificateExpirationDate 7/12/2025
FacilityType Waiver

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