19D2141235 CLIA NUMBER - WALMART PHARMACY #10-5056

Laboratory Demographics

  • CLIA Code: 19D2141235
  • Facility Name: WALMART PHARMACY #10-5056
  • Facility Address: 17585 AIRLINE HWY
    PRAIRIEVILLE, LA
    ZIP 70769
  • Facility Phone: 225 677-7390
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALISON L. WILLIAMS
  • NPI Number: 1669871562
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 19D2141235
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-5056
Street 17585 AIRLINE HWY
City PRAIRIEVILLE
State LA
ZIP 70769
Phone 225 677-7390
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 ALISON L. WILLIAMS

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