19D2284031 CLIA NUMBER - CVS PHARMACY #08961 LOUISIANA CVS PHARMACY

Laboratory Demographics

  • CLIA Code: 19D2284031
  • Facility Name: CVS PHARMACY #08961 LOUISIANA CVS PHARMACY
  • Facility Address: 12880 AIRLINE HWY
    BATON ROUGE, LA
    ZIP 70817
  • Facility Phone: 225 751-3611
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FRANKLY VAN
  • NPI Number: 1053869081
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 19D2284031
LAB Type Pharmacy
Facility Name CVS PHARMACY #08961 LOUISIANA CVS PHARMACY
Street 12880 AIRLINE HWY
City BATON ROUGE
State LA
ZIP 70817
Phone 225 751-3611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2025
Certificate Expiration Date 6/14/2027
Facility Type Pharmacy
Lab Director FRANKLY VAN

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