19D2220321 CLIA NUMBER - WALGREENS #15402

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Laboratory Demographics

CLIA Number: 19D2220321

Facility Name: WALGREENS #15402

Facility Address:
625 HOMER RD
MINDEN, LA
ZIP 71055
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Facility Phone Number: 318 371-5149

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1720415128

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	19D2220321
LAB Type	Pharmacy
Facility Name	WALGREENS #15402
Street	625 HOMER RD
City	MINDEN
State	LA
ZIP	71055
Phone	318 371-5149
CertificateType	4
CertificateEffectiveDate	4/12/2023
CertificateExpirationDate	4/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024