19D2129657 CLIA NUMBER - WALMART PHARMACY 10-3868

Laboratory Demographics

  • CLIA Code: 19D2129657
  • Facility Name: WALMART PHARMACY 10-3868
  • Facility Address: 1125 SHREVEPORT BARKSIDE HWY
    SHREVEPORT, LA
    ZIP 71105
  • Facility Phone: 318 861-9212
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIKA MORGAN
  • NPI Number: 1437358058
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2129657
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3868
Street 1125 SHREVEPORT BARKSIDE HWY
City SHREVEPORT
State LA
ZIP 71105
Phone 318 861-9212
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 ERIKA MORGAN

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