19D2221169 CLIA NUMBER - WALGREENS #15546

Laboratory Demographics

  • CLIA Code: 19D2221169
  • Facility Name: WALGREENS #15546
  • Facility Address: 9303 PARK AVE
    HOUMA, LA
    ZIP 70363
  • Facility Phone: 985 873-2943
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RON M. LEBOEUF
  • NPI Number: 1265855183
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2221169
LAB Type Pharmacy
Facility Name WALGREENS #15546
Street 9303 PARK AVE
City HOUMA
State LA
ZIP 70363
Phone 985 873-2943
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Pharmacy
Lab Director RON M. LEBOEUF

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