19D1036455 CLIA NUMBER - MCDONALD PHARMACY

Laboratory Demographics

  • CLIA Code: 19D1036455
  • Facility Name: MCDONALD PHARMACY
  • Facility Address: 1701 CHARTER STREET
    JACKSON, LA
    ZIP 70748
  • Facility Phone: 225 634-2470
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL K. TOMB
  • NPI Number: 1326029448
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D1036455
LAB Type Pharmacy
Facility Name MCDONALD PHARMACY
Street 1701 CHARTER STREET
City JACKSON
State LA
ZIP 70748
Phone 225 634-2470
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Pharmacy
Lab Director MICHAEL K. TOMB

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