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19D2226119 CLIA NUMBER - WALGREENS #13876

Laboratory Demographics

CLIA Number: 19D2226119

Facility Name: WALGREENS #13876

Facility Address:
2180 GAUSE BLVD W
SLIDELL, LA
ZIP 70460
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Facility Phone Number: 985 646-1140

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1538445390

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 19D2226119
LAB Type Pharmacy
Facility Name WALGREENS #13876
Street 2180 GAUSE BLVD W
City SLIDELL
State LA
ZIP 70460
Phone 985 646-1140
CertificateType 4
CertificateEffectiveDate 5/26/2023
CertificateExpirationDate 5/25/2025
FacilityType Waiver

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