19D2235895 CLIA NUMBER - CVS/PHARMACY #5284 LOUISIANA CVS PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 19D2235895
  • Facility Name: CVS/PHARMACY #5284 LOUISIANA CVS PHARMACY, LLC
  • Facility Address: 705 BERTRAND DR
    LAFAYETTE, LA
    ZIP 70506
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MIRANDA DEJEAN
  • NPI Number: 1336243278
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2235895
LAB Type Pharmacy
Facility Name CVS/PHARMACY #5284 LOUISIANA CVS PHARMACY, LLC
Street 705 BERTRAND DR
City LAFAYETTE
State LA
ZIP 70506
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Pharmacy
Lab Director MIRANDA DEJEAN

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