04D2096824 CLIA NUMBER - WALMART PHARMACY 10-4579

Laboratory Demographics

  • CLIA Code: 04D2096824
  • Facility Name: WALMART PHARMACY 10-4579
  • Facility Address: 8600 HWY 71 S
    FORT SMITH, AR
    ZIP 72908
  • Facility Phone: 000 479-2736
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JODY HESTER
  • NPI Number: 1558741611
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2096824
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4579
Street 8600 HWY 71 S
City FORT SMITH
State AR
ZIP 72908
Phone 000 479-2736
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Pharmacy
Lab Director JODY HESTER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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