19D2099844 CLIA NUMBER - WALMART PHARMACY 10-5204

Laboratory Demographics

  • CLIA Code: 19D2099844
  • Facility Name: WALMART PHARMACY 10-5204
  • Facility Address: 4000 BARKSDALE BLVD
    BOSSIER CITY, LA
    ZIP 71112
  • Facility Phone: 479 273-6418
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TUYEN TRAN
  • NPI Number: 1033595251
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2099844
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5204
Street 4000 BARKSDALE BLVD
City BOSSIER CITY
State LA
ZIP 71112
Phone 479 273-6418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Pharmacy
Lab Director TUYEN TRAN

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