19D2038559 CLIA NUMBER - WALGREENS #10537

Laboratory Demographics

  • CLIA Code: 19D2038559
  • Facility Name: WALGREENS #10537
  • Facility Address: 916 N PINE STREET
    DERIDDER, LA
    ZIP 70634
  • Facility Phone: 337 462-2019
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFERY S. MULLICAN
  • NPI Number: 1427259852
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2038559
LAB Type Pharmacy
Facility Name WALGREENS #10537
Street 916 N PINE STREET
City DERIDDER
State LA
ZIP 70634
Phone 337 462-2019
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 JEFFERY S. MULLICAN

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