19D2218202 CLIA NUMBER - WALGREENS #10267

Laboratory Demographics

  • CLIA Code: 19D2218202
  • Facility Name: WALGREENS #10267
  • Facility Address: 5831 W PARK AVE
    HOUMA, LA
    ZIP 70364
  • Facility Phone: 985 868-9118
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TANIA T. PORTIER
  • NPI Number: 1215068804
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2218202
LAB Type Pharmacy
Facility Name WALGREENS #10267
Street 5831 W PARK AVE
City HOUMA
State LA
ZIP 70364
Phone 985 868-9118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director TANIA T. PORTIER

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