19D2205623 CLIA NUMBER - WALGREENS #17338

Laboratory Demographics

  • CLIA Code: 19D2205623
  • Facility Name: WALGREENS #17338
  • Facility Address: 761 PIERREMONT ROAD
    SHREVEPORT, LA
    ZIP 71106
  • Facility Phone: 318 861-3666
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANNY PATEL
  • NPI Number: 1407371701
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2205623
LAB Type Pharmacy
Facility Name WALGREENS #17338
Street 761 PIERREMONT ROAD
City SHREVEPORT
State LA
ZIP 71106
Phone 318 861-3666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Pharmacy
Lab Director DANNY PATEL

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