19D2138572 CLIA NUMBER - WALMART PHARMACY 10-0505

Laboratory Demographics

  • CLIA Code: 19D2138572
  • Facility Name: WALMART PHARMACY 10-0505
  • Facility Address: 1125 N PINE STREET
    DERIDDER, LA
    ZIP 70634
  • Facility Phone: 337 462-5794
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL P. DAIGLE
  • NPI Number: 1982621223
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2138572
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0505
Street 1125 N PINE STREET
City DERIDDER
State LA
ZIP 70634
Phone 337 462-5794
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2025
Certificate Expiration Date 10/19/2027
Facility Type Pharmacy
Lab Director DANIEL P. DAIGLE

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