19D2066206 CLIA NUMBER - WALGREENS #02982

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Laboratory Demographics

CLIA Number: 19D2066206

Facility Name: WALGREENS #02982

Facility Address:
5450 PLANK ROAD
BATON ROUGE, LA
ZIP 70805
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Facility Phone Number: 225 355-9782

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1306851563

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	19D2066206
LAB Type	Pharmacy
Facility Name	WALGREENS #02982
Street	5450 PLANK ROAD
City	BATON ROUGE
State	LA
ZIP	70805
Phone	225 355-9782
CertificateType	4
CertificateEffectiveDate	7/19/2023
CertificateExpirationDate	7/18/2025
FacilityType	Waiver

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