19D2066178 CLIA NUMBER - WALGREENS #09861

Laboratory Demographics

  • CLIA Code: 19D2066178
  • Facility Name: WALGREENS #09861
  • Facility Address: 13500 HIGHWAY 90
    BOUTTE, LA
    ZIP 70039
  • Facility Phone: 985 331-1866
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LATASHA D. LUMAR
  • NPI Number: 1780699967
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2066178
LAB Type Pharmacy
Facility Name WALGREENS #09861
Street 13500 HIGHWAY 90
City BOUTTE
State LA
ZIP 70039
Phone 985 331-1866
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director LATASHA D. LUMAR

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