19D1033844 CLIA NUMBER - ALBERTSONS PHARMACY #0218 ALBERTSONS LLC

Laboratory Demographics

  • CLIA Code: 19D1033844
  • Facility Name: ALBERTSONS PHARMACY #0218 ALBERTSONS LLC
  • Facility Address: 105 E SOUTHFIELD ROAD
    SHREVEPORT, LA
    ZIP 71105
  • Facility Phone: 318 861-2431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CARNELIA GREENE
  • NPI Number: 1134167224
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D1033844
LAB Type Pharmacy
Facility Name ALBERTSONS PHARMACY #0218 ALBERTSONS LLC
Street 105 E SOUTHFIELD ROAD
City SHREVEPORT
State LA
ZIP 71105
Phone 318 861-2431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Pharmacy
Lab Director CARNELIA GREENE

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