04D2127259 CLIA NUMBER - WALMART PHARMACY 10-1114

Laboratory Demographics

  • CLIA Code: 04D2127259
  • Facility Name: WALMART PHARMACY 10-1114
  • Facility Address: 409 SYLAMORE AVE
    MOUNTAIN VIEW, AR
    ZIP 72560
  • Facility Phone: 870 269-4295
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. CHELSEA DAVIS
  • NPI Number: 1568489060
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2127259
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1114
Street 409 SYLAMORE AVE
City MOUNTAIN VIEW
State AR
ZIP 72560
Phone 870 269-4295
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Pharmacy
Lab Director MS. CHELSEA DAVIS

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