19D2220413 CLIA NUMBER - WALGREENS #15366

Laboratory Demographics

  • CLIA Code: 19D2220413
  • Facility Name: WALGREENS #15366
  • Facility Address: 220 N ALEXANDER AVE
    PORT ALLEN, LA
    ZIP 70767
  • Facility Phone: 225 382-0665
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYLA D. BROWN
  • NPI Number: 1598006934
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2220413
LAB Type Pharmacy
Facility Name WALGREENS #15366
Street 220 N ALEXANDER AVE
City PORT ALLEN
State LA
ZIP 70767
Phone 225 382-0665
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 KYLA D. BROWN

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