19D2037509 CLIA NUMBER - WALGREENS #12428

Laboratory Demographics

  • CLIA Code: 19D2037509
  • Facility Name: WALGREENS #12428
  • Facility Address: 920 W GLORIA SWITCH ROAD
    LAFAYETTE, LA
    ZIP 70507
  • Facility Phone: 337 896-0128
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BETHANY S. LAVERGNE
  • NPI Number: 1154651438
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2037509
LAB Type Pharmacy
Facility Name WALGREENS #12428
Street 920 W GLORIA SWITCH ROAD
City LAFAYETTE
State LA
ZIP 70507
Phone 337 896-0128
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director BETHANY S. LAVERGNE

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