19D2129677 CLIA NUMBER - WALMART PHARMACY #10-5832

Laboratory Demographics

  • CLIA Code: 19D2129677
  • Facility Name: WALMART PHARMACY #10-5832
  • Facility Address: 3009 E CAUSEWAY APPROACH
    MANDEVILLE, LA
    ZIP 70448
  • Facility Phone: 985 626-1118
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH F. MCCRARY
  • NPI Number: 1699143453
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2129677
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-5832
Street 3009 E CAUSEWAY APPROACH
City MANDEVILLE
State LA
ZIP 70448
Phone 985 626-1118
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 ELIZABETH F. MCCRARY

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