19D2022516 CLIA NUMBER - WALGREENS # 11762

Laboratory Demographics

  • CLIA Code: 19D2022516
  • Facility Name: WALGREENS # 11762
  • Facility Address: 10200 FLORIDA BLVD
    WALKER, LA
    ZIP 70785
  • Facility Phone: 225 664-5181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAOTUAN T. PHAM
  • NPI Number: 1477712560
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2022516
LAB Type Pharmacy
Facility Name WALGREENS # 11762
Street 10200 FLORIDA BLVD
City WALKER
State LA
ZIP 70785
Phone 225 664-5181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Pharmacy
Lab Director CAOTUAN T. PHAM

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