19D2140978 CLIA NUMBER - WALMART PHARMACY #3288

Laboratory Demographics

  • CLIA Code: 19D2140978
  • Facility Name: WALMART PHARMACY #3288
  • Facility Address: 10200 SULLIVAN RD
    BATON ROUGE, LA
    ZIP 70818
  • Facility Phone: 225 262-1413
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BENJAMIN Q. PHAM
  • NPI Number: 1235156506
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2140978
LAB Type Pharmacy
Facility Name WALMART PHARMACY #3288
Street 10200 SULLIVAN RD
City BATON ROUGE
State LA
ZIP 70818
Phone 225 262-1413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Pharmacy
Lab Director BENJAMIN Q. PHAM

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