04D2130447 CLIA NUMBER - WALMART PHARMACY 10-0714

Laboratory Demographics

  • CLIA Code: 04D2130447
  • Facility Name: WALMART PHARMACY 10-0714
  • Facility Address: 602 SHELIA STREET
    WEST HELENA, AR
    ZIP 72390
  • Facility Phone: 870 572-6741
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULIANA OGUH
  • NPI Number: 1417974817
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2130447
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0714
Street 602 SHELIA STREET
City WEST HELENA
State AR
ZIP 72390
Phone 870 572-6741
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Pharmacy
Lab Director JULIANA OGUH

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