19D2129636 CLIA NUMBER - WALMART PHARMACY 10-502

Laboratory Demographics

  • CLIA Code: 19D2129636
  • Facility Name: WALMART PHARMACY 10-502
  • Facility Address: 16759 HWY 3235
    GALLIANO, LA
    ZIP 70354
  • Facility Phone: 985 632-4727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEMI M. DAVIS
  • NPI Number: 1629096110
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2129636
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-502
Street 16759 HWY 3235
City GALLIANO
State LA
ZIP 70354
Phone 985 632-4727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2025
Certificate Expiration Date 4/23/2027
Facility Type Pharmacy
Lab Director DEMI M. DAVIS

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