19D2015516 CLIA NUMBER - WALGREENS # 06219

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Laboratory Demographics

CLIA Number: 19D2015516

Facility Name: WALGREENS # 06219

Facility Address:
2636 RYAN ST
LAKE CHARLES, LA
ZIP 70601
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Facility Phone Number: 337 433-4178

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1629084017

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	19D2015516
LAB Type	Pharmacy
Facility Name	WALGREENS # 06219
Street	2636 RYAN ST
City	LAKE CHARLES
State	LA
ZIP	70601
Phone	337 433-4178
CertificateType	4
CertificateEffectiveDate	4/16/2023
CertificateExpirationDate	4/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024