19D2015510 CLIA NUMBER - WALGREENS # 04626

Laboratory Demographics

  • CLIA Code: 19D2015510
  • Facility Name: WALGREENS # 04626
  • Facility Address: 2517 KALISTE SALOOM RD
    LAFAYETTE, LA
    ZIP 70508
  • Facility Phone: 337 216-9187
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COURNEISHIA M. JAMES
  • NPI Number: 1689689853
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2015510
LAB Type Pharmacy
Facility Name WALGREENS # 04626
Street 2517 KALISTE SALOOM RD
City LAFAYETTE
State LA
ZIP 70508
Phone 337 216-9187
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type Pharmacy
Lab Director COURNEISHIA M. JAMES

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