19D2038561 CLIA NUMBER - WALGREENS 10538

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Laboratory Demographics

CLIA Number: 19D2038561

Facility Name: WALGREENS 10538

Facility Address:
2008 SOUTH 5TH STREET
LEESVILLE, LA
ZIP 71446
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Facility Phone Number: 337 239-2285

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205957289

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	19D2038561
LAB Type	Pharmacy
Facility Name	WALGREENS 10538
Street	2008 SOUTH 5TH STREET
City	LEESVILLE
State	LA
ZIP	71446
Phone	337 239-2285
CertificateType	4
CertificateEffectiveDate	11/28/2023
CertificateExpirationDate	11/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024