19D1033715 CLIA NUMBER - ALBERTSONS PHARMACY #0120

Laboratory Demographics

  • CLIA Code: 19D1033715
  • Facility Name: ALBERTSONS PHARMACY #0120
  • Facility Address: 2678 JOHNSTON STREET
    LAFAYETTE, LA
    ZIP 70503
  • Facility Phone: 337 233-2265
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON CAVALIER
  • NPI Number: 1144267691
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D1033715
LAB Type Pharmacy
Facility Name ALBERTSONS PHARMACY #0120
Street 2678 JOHNSTON STREET
City LAFAYETTE
State LA
ZIP 70503
Phone 337 233-2265
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Pharmacy
Lab Director JASON CAVALIER

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