19D2015515 CLIA NUMBER - WALGREENS #10508

Laboratory Demographics

  • CLIA Code: 19D2015515
  • Facility Name: WALGREENS #10508
  • Facility Address: 4097 RYAN ST
    LAKE CHARLES, LA
    ZIP 70605
  • Facility Phone: 337 474-0434
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELISABETH L. CONLEY
  • NPI Number: 1477675767
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2015515
LAB Type Pharmacy
Facility Name WALGREENS #10508
Street 4097 RYAN ST
City LAKE CHARLES
State LA
ZIP 70605
Phone 337 474-0434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director ELISABETH L. CONLEY

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This page was last updated on: 6/4/2025