18D2229486 CLIA NUMBER - WALGREENS #17404

Laboratory Demographics

  • CLIA Code: 18D2229486
  • Facility Name: WALGREENS #17404
  • Facility Address: 10 CHARBY HOLLOW RD
    MARTIN, KY
    ZIP 41649
  • Facility Phone: 606 285-9908
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. STACIA R. CONLEY
  • NPI Number: 1427571777
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2229486
LAB Type Pharmacy
Facility Name WALGREENS #17404
Street 10 CHARBY HOLLOW RD
City MARTIN
State KY
ZIP 41649
Phone 606 285-9908
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director MS. STACIA R. CONLEY

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