19D2038518 CLIA NUMBER - WALGREENS #9645

Laboratory Demographics

  • CLIA Code: 19D2038518
  • Facility Name: WALGREENS #9645
  • Facility Address: 73626 HIGHWAY 25
    COVINGTON, LA
    ZIP 70435
  • Facility Phone: 504 473-3074
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF J. GAUDE
  • NPI Number: 1962417147
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2038518
LAB Type Pharmacy
Facility Name WALGREENS #9645
Street 73626 HIGHWAY 25
City COVINGTON
State LA
ZIP 70435
Phone 504 473-3074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2024
Certificate Expiration Date 8/20/2026
Facility Type Pharmacy
Lab Director JEFF J. GAUDE

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