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18D2288434 CLIA NUMBER - WALGREENS 17796

Laboratory Demographics

CLIA Number: 18D2288434

Facility Name: WALGREENS 17796

Facility Address:
551 MAIN STREET NORTH
MC KEE, KY
ZIP 40447
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Facility Phone Number: 606 287-7187

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1386167443

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 18D2288434
LAB Type Pharmacy
Facility Name WALGREENS 17796
Street 551 MAIN STREET NORTH
City MC KEE
State KY
ZIP 40447
Phone 606 287-7187
CertificateType 4
CertificateEffectiveDate 8/25/2023
CertificateExpirationDate 8/24/2025
FacilityType Waiver

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