19D2290505 CLIA NUMBER - HEADRICK'S DRUG STORE

Laboratory Demographics

  • CLIA Code: 19D2290505
  • Facility Name: HEADRICK'S DRUG STORE
  • Facility Address: 204 MAIN STREET
    LOGANSPORT, LA
    ZIP 71049
  • Facility Phone: (318) 697-4381
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHOMICHAEL L. STEPHENS
  • NPI Number: 1508396656
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2290505
LAB Type Pharmacy
Facility Name HEADRICK'S DRUG STORE
Street 204 MAIN STREET
City LOGANSPORT
State LA
ZIP 71049
Phone 3186974381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2025
Certificate Expiration Date 9/25/2027
Facility Type Pharmacy
Lab Director SHOMICHAEL L. STEPHENS

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This page was last updated on: 5/18/2026