19D2044112 CLIA NUMBER - WALGREENS #01657

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Laboratory Demographics

CLIA Number: 19D2044112

Facility Name: WALGREENS #01657

Facility Address:
3333 MASONIC DRIVE
ALEXANDRIA, LA
ZIP 71301
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Facility Phone Number: 318 445-6386

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1508871781

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	19D2044112
LAB Type	Pharmacy
Facility Name	WALGREENS #01657
Street	3333 MASONIC DRIVE
City	ALEXANDRIA
State	LA
ZIP	71301
Phone	318 445-6386
CertificateType	4
CertificateEffectiveDate	1/21/2023
CertificateExpirationDate	1/20/2025
FacilityType	Waiver

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