04D2129833 CLIA NUMBER - WALMART PHARMACY 10-0167

Laboratory Demographics

  • CLIA Code: 04D2129833
  • Facility Name: WALMART PHARMACY 10-0167
  • Facility Address: 910 UNITY RD
    CROSSETT, AR
    ZIP 71635
  • Facility Phone: 870 364-7205
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA L. LONG
  • NPI Number: 1245257633
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2129833
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0167
Street 910 UNITY RD
City CROSSETT
State AR
ZIP 71635
Phone 870 364-7205
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director JESSICA L. LONG

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