04D2132119 CLIA NUMBER - WALMART PHARMACY 10-0171

Laboratory Demographics

  • CLIA Code: 04D2132119
  • Facility Name: WALMART PHARMACY 10-0171
  • Facility Address: 950 CALIFORNIA AVE
    CAMDEN, AR
    ZIP 71701
  • Facility Phone: 870 836-0500
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY DICKEY
  • NPI Number: 1083631592
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2132119
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0171
Street 950 CALIFORNIA AVE
City CAMDEN
State AR
ZIP 71701
Phone 870 836-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2025
Certificate Expiration Date 6/12/2027
Facility Type Pharmacy
Lab Director KELLY DICKEY

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