04D2111728 CLIA NUMBER - WALMART PHARMACY 10-5790

Laboratory Demographics

  • CLIA Code: 04D2111728
  • Facility Name: WALMART PHARMACY 10-5790
  • Facility Address: 1544 MALVERN AVE
    HOT SPRINGS, AR
    ZIP 71901
  • Facility Phone: 479 258-2243
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAMELA L. ANTHONY
  • NPI Number: 1891143020
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2111728
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5790
Street 1544 MALVERN AVE
City HOT SPRINGS
State AR
ZIP 71901
Phone 479 258-2243
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Pharmacy
Lab Director PAMELA L. ANTHONY

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