19D2220333 CLIA NUMBER - WALGREENS #11138

Laboratory Demographics

  • CLIA Code: 19D2220333
  • Facility Name: WALGREENS #11138
  • Facility Address: 1415 SAINT CHARLES ST
    HOUMA, LA
    ZIP 70360
  • Facility Phone: 985 868-4033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHWANDA THIBODAUX
  • NPI Number: 1568645513
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2220333
LAB Type Pharmacy
Facility Name WALGREENS #11138
Street 1415 SAINT CHARLES ST
City HOUMA
State LA
ZIP 70360
Phone 985 868-4033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director SHWANDA THIBODAUX

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