19D2142344 CLIA NUMBER - WALMART PHARMACY #10-4683

Laboratory Demographics

  • CLIA Code: 19D2142344
  • Facility Name: WALMART PHARMACY #10-4683
  • Facility Address: 10550 BURBANK DR
    BATON ROUGE, LA
    ZIP 70810
  • Facility Phone: 225 412-5498
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KHANHMINH T. NGUYEN
  • NPI Number: 1346667821
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2142344
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4683
Street 10550 BURBANK DR
City BATON ROUGE
State LA
ZIP 70810
Phone 225 412-5498
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Pharmacy
Lab Director KHANHMINH T. NGUYEN

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