19D2134940 CLIA NUMBER - WALMART PHARMACY 10-0405

Laboratory Demographics

  • CLIA Code: 19D2134940
  • Facility Name: WALMART PHARMACY 10-0405
  • Facility Address: 2204 S 5TH STREET
    LEESVILLE, LA
    ZIP 71446
  • Facility Phone: 337 238-9305
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDER RAVEN
  • NPI Number: 1336166677
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2134940
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0405
Street 2204 S 5TH STREET
City LEESVILLE
State LA
ZIP 71446
Phone 337 238-9305
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Pharmacy
Lab Director ALEXANDER RAVEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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