19D2284138 CLIA NUMBER - CVS PHARMACY #05396 LOUISIANA CVS PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 19D2284138
  • Facility Name: CVS PHARMACY #05396 LOUISIANA CVS PHARMACY LLC
  • Facility Address: 4890 BARKSDALE BLVD
    BOSSIER CITY, LA
    ZIP 71112
  • Facility Phone: 318 747-4330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN REDDING
  • NPI Number: 1437403672
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2284138
LAB Type Pharmacy
Facility Name CVS PHARMACY #05396 LOUISIANA CVS PHARMACY LLC
Street 4890 BARKSDALE BLVD
City BOSSIER CITY
State LA
ZIP 71112
Phone 318 747-4330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2025
Certificate Expiration Date 6/18/2027
Facility Type Pharmacy
Lab Director JUSTIN REDDING

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