19D2038539 CLIA NUMBER - WALGREENS #04192

Laboratory Demographics

  • CLIA Code: 19D2038539
  • Facility Name: WALGREENS #04192
  • Facility Address: 1017 EAST ADMIRAL DOYLE DRIVE
    NEW IBERIA, LA
    ZIP 70560
  • Facility Phone: 337 367-7979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER MASON
  • NPI Number: 1841205002
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2038539
LAB Type Pharmacy
Facility Name WALGREENS #04192
Street 1017 EAST ADMIRAL DOYLE DRIVE
City NEW IBERIA
State LA
ZIP 70560
Phone 337 367-7979
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 CHRISTOPHER MASON

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