19D2098172 CLIA NUMBER - WALMART PHARMACY 10-6583

Laboratory Demographics

  • CLIA Code: 19D2098172
  • Facility Name: WALMART PHARMACY 10-6583
  • Facility Address: 2011 RYAN STREET
    LAKE CHARLES, LA
    ZIP 70601
  • Facility Phone: 337 508-3867
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MANJU KATIYAR
  • NPI Number: 1780055301
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2098172
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6583
Street 2011 RYAN STREET
City LAKE CHARLES
State LA
ZIP 70601
Phone 337 508-3867
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Pharmacy
Lab Director MANJU KATIYAR

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