19D2129670 CLIA NUMBER - WALMART PHARMACY 10-531

Laboratory Demographics

  • CLIA Code: 19D2129670
  • Facility Name: WALMART PHARMACY 10-531
  • Facility Address: 3142 AMBASSADOR CAFFERY PKWY
    LAFAYETTE, LA
    ZIP 70506
  • Facility Phone: 337 989-4095
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANE M. LANDRY
  • NPI Number: 1235156597
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2129670
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-531
Street 3142 AMBASSADOR CAFFERY PKWY
City LAFAYETTE
State LA
ZIP 70506
Phone 337 989-4095
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 SHANE M. LANDRY

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