19D2037517 CLIA NUMBER - WALGREENS #10536

Laboratory Demographics

  • CLIA Code: 19D2037517
  • Facility Name: WALGREENS #10536
  • Facility Address: 1930 E MADISON AVENUE
    BASTROP, LA
    ZIP 71220
  • Facility Phone: 318 281-7410
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VICTORIA HERRINGTON
  • NPI Number: 1487733747
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2037517
LAB Type Pharmacy
Facility Name WALGREENS #10536
Street 1930 E MADISON AVENUE
City BASTROP
State LA
ZIP 71220
Phone 318 281-7410
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director VICTORIA HERRINGTON

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