19D1033567 CLIA NUMBER - ALBERTSONS PHARMACY #0712

Laboratory Demographics

  • CLIA Code: 19D1033567
  • Facility Name: ALBERTSONS PHARMACY #0712
  • Facility Address: 9650 AIRLINE HIGHWAY
    BATON ROUGE, LA
    ZIP 70815
  • Facility Phone: 225 926-9604
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARY GREENE
  • NPI Number: 1073553434
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D1033567
LAB Type Pharmacy
Facility Name ALBERTSONS PHARMACY #0712
Street 9650 AIRLINE HIGHWAY
City BATON ROUGE
State LA
ZIP 70815
Phone 225 926-9604
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Pharmacy
Lab Director MARY GREENE

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