19D2141233 CLIA NUMBER - WALMART PHARMACY #10-4295

Laboratory Demographics

  • CLIA Code: 19D2141233
  • Facility Name: WALMART PHARMACY #10-4295
  • Facility Address: 6225 COLISEUM BLVD
    ALEXANDRIA, LA
    ZIP 71303
  • Facility Phone: 318 448-4841
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GREG W. HACKNEY
  • NPI Number: 1215102082
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 19D2141233
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4295
Street 6225 COLISEUM BLVD
City ALEXANDRIA
State LA
ZIP 71303
Phone 318 448-4841
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2023
Certificate Expiration Date 12/10/2025
Facility Type Pharmacy
Lab Director GREG W. HACKNEY

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