19D2145724 CLIA NUMBER - WALMART PHARMACY #10-402

Laboratory Demographics

  • CLIA Code: 19D2145724
  • Facility Name: WALMART PHARMACY #10-402
  • Facility Address: 1932 REES ST
    BREAUX BRIDGE, LA
    ZIP 70517
  • Facility Phone: 337 332-1100
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DONAVAN J. DANIELS
  • NPI Number: 1083817829
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2145724
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-402
Street 1932 REES ST
City BREAUX BRIDGE
State LA
ZIP 70517
Phone 337 332-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Pharmacy
Lab Director DONAVAN J. DANIELS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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