19D2038544 CLIA NUMBER - WALGREENS #06577

Laboratory Demographics

  • CLIA Code: 19D2038544
  • Facility Name: WALGREENS #06577
  • Facility Address: 2755 COUNTRY CLUB ROAD
    LAKE CHARLES, LA
    ZIP 70605
  • Facility Phone: 337 477-7564
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LARRY COLLINS
  • NPI Number: 1982610473
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2038544
LAB Type Pharmacy
Facility Name WALGREENS #06577
Street 2755 COUNTRY CLUB ROAD
City LAKE CHARLES
State LA
ZIP 70605
Phone 337 477-7564
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Pharmacy
Lab Director LARRY COLLINS

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