19D2015539 CLIA NUMBER - WALGREENS # 07004

Laboratory Demographics

  • CLIA Code: 19D2015539
  • Facility Name: WALGREENS # 07004
  • Facility Address: 2107 AIRLINE DR
    BOSSIER CITY, LA
    ZIP 71111
  • Facility Phone: 318 742-5590
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLA B. OGUNDIYIA
  • NPI Number: 1760497937
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2015539
LAB Type Pharmacy
Facility Name WALGREENS # 07004
Street 2107 AIRLINE DR
City BOSSIER CITY
State LA
ZIP 71111
Phone 318 742-5590
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director OLA B. OGUNDIYIA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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