19D2101858 CLIA NUMBER - WALMART PHARMACY 10-6932

Laboratory Demographics

  • CLIA Code: 19D2101858
  • Facility Name: WALMART PHARMACY 10-6932
  • Facility Address: 4701 NORTHPORT BLVD
    SHREVEPORT, LA
    ZIP 71107
  • Facility Phone: 479 273-6418
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NEAL SAUVIAC
  • NPI Number: 1336513993
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 19D2101858
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6932
Street 4701 NORTHPORT BLVD
City SHREVEPORT
State LA
ZIP 71107
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 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Pharmacy
Lab Director NEAL SAUVIAC

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