19D2015543 CLIA NUMBER - WALGREENS #03440

Laboratory Demographics

  • CLIA Code: 19D2015543
  • Facility Name: WALGREENS #03440
  • Facility Address: 2880 HIGHWAY 190
    MANDEVILLE, LA
    ZIP 70471
  • Facility Phone: 985 624-8548
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REBECCA E. CHEDOTAL
  • NPI Number: 1598770752
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2015543
LAB Type Pharmacy
Facility Name WALGREENS #03440
Street 2880 HIGHWAY 190
City MANDEVILLE
State LA
ZIP 70471
Phone 985 624-8548
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Pharmacy
Lab Director REBECCA E. CHEDOTAL

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