19D2283956 CLIA NUMBER - CVS PHARMACY #05360 LOUISIANA CVS PHARMACY

Laboratory Demographics

  • CLIA Code: 19D2283956
  • Facility Name: CVS PHARMACY #05360 LOUISIANA CVS PHARMACY
  • Facility Address: 6935 PINES RD
    SHREVEPORT, LA
    ZIP 71129
  • Facility Phone: 318 688-7912
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES BRUCE
  • NPI Number: 1346344280
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2283956
LAB Type Pharmacy
Facility Name CVS PHARMACY #05360 LOUISIANA CVS PHARMACY
Street 6935 PINES RD
City SHREVEPORT
State LA
ZIP 71129
Phone 318 688-7912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Pharmacy
Lab Director CHARLES BRUCE

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