19D2015522 CLIA NUMBER - WALGREENS 04140

Laboratory Demographics

  • CLIA Code: 19D2015522
  • Facility Name: WALGREENS 04140
  • Facility Address: 195 N CANAL BLVD
    THIBODAUX, LA
    ZIP 70301
  • Facility Phone: 985 447-2456
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDA F. KEYS
  • NPI Number: 1205841467
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2015522
LAB Type Pharmacy
Facility Name WALGREENS 04140
Street 195 N CANAL BLVD
City THIBODAUX
State LA
ZIP 70301
Phone 985 447-2456
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Pharmacy
Lab Director LINDA F. KEYS

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