18D2229817 CLIA NUMBER - WALGREENS #17180

Laboratory Demographics

  • CLIA Code: 18D2229817
  • Facility Name: WALGREENS #17180
  • Facility Address: 1040 RICHMOND ST
    MOUNT VERNON, KY
    ZIP 40456
  • Facility Phone: 606 256-9207
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. KIMBERLY L. BULLEN
  • NPI Number: 1619490943
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2229817
LAB Type Pharmacy
Facility Name WALGREENS #17180
Street 1040 RICHMOND ST
City MOUNT VERNON
State KY
ZIP 40456
Phone 606 256-9207
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Pharmacy
Lab Director DR. KIMBERLY L. BULLEN

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