19D2038568 CLIA NUMBER - WALGREENS 05633

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Laboratory Demographics

CLIA Number: 19D2038568

Facility Name: WALGREENS 05633

Facility Address:
2570 BARATARIA BOULEVARD
MARRERO, LA
ZIP 70072
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Facility Phone Number: 504 341-0005

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1346256823

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	19D2038568
LAB Type	Pharmacy
Facility Name	WALGREENS 05633
Street	2570 BARATARIA BOULEVARD
City	MARRERO
State	LA
ZIP	70072
Phone	504 341-0005
CertificateType	4
CertificateEffectiveDate	9/7/2023
CertificateExpirationDate	9/6/2025
FacilityType	Waiver

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