19D2037518 CLIA NUMBER - WALGREENS #13604

Laboratory Demographics

  • CLIA Code: 19D2037518
  • Facility Name: WALGREENS #13604
  • Facility Address: 300 WEST OAK STREET
    AMITE, LA
    ZIP 70422
  • Facility Phone: 985 747-8342
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT J. ESPONGE
  • NPI Number: 1174837074
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2037518
LAB Type Pharmacy
Facility Name WALGREENS #13604
Street 300 WEST OAK STREET
City AMITE
State LA
ZIP 70422
Phone 985 747-8342
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 ROBERT J. ESPONGE

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