19D2039773 CLIA NUMBER - WALGREENS #21552

Laboratory Demographics

  • CLIA Code: 19D2039773
  • Facility Name: WALGREENS #21552
  • Facility Address: 3916 NW EVANGELINE THRUWAY SUITE B
    CARENCRO, LA
    ZIP 70520
  • Facility Phone: 337 886-3660
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BROOKE A. WALKER
  • NPI Number: 1710663042
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2039773
LAB Type Pharmacy
Facility Name WALGREENS #21552
Street 3916 NW EVANGELINE THRUWAY SUITE B
City CARENCRO
State LA
ZIP 70520
Phone 337 886-3660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2024
Certificate Expiration Date 4/16/2026
Facility Type Pharmacy
Lab Director BROOKE A. WALKER

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