19D2289516 CLIA NUMBER - WALGREENS 17055

Laboratory Demographics

  • CLIA Code: 19D2289516
  • Facility Name: WALGREENS 17055
  • Facility Address: 2323 FORSYTHE AVENUE
    MONROE, LA
    ZIP 71201
  • Facility Phone: 318 361-5898
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL L. RUSSEL
  • NPI Number: 1093231763
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2289516
LAB Type Pharmacy
Facility Name WALGREENS 17055
Street 2323 FORSYTHE AVENUE
City MONROE
State LA
ZIP 71201
Phone 318 361-5898
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Pharmacy
Lab Director DANIEL L. RUSSEL

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