19D2038553 CLIA NUMBER - WALGREENS 10126

Laboratory Demographics

  • CLIA Code: 19D2038553
  • Facility Name: WALGREENS 10126
  • Facility Address: 105 SAINT NAZAIRE ROAD
    BROUSSARD, LA
    ZIP 70518
  • Facility Phone: 337 837-1640
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN T. PERRODIN
  • NPI Number: 1861661597
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2038553
LAB Type Pharmacy
Facility Name WALGREENS 10126
Street 105 SAINT NAZAIRE ROAD
City BROUSSARD
State LA
ZIP 70518
Phone 337 837-1640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2025
Certificate Expiration Date 9/6/2027
Facility Type Pharmacy
Lab Director KEVIN T. PERRODIN

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