04D2132907 CLIA NUMBER - WALMART PHARMACY 10-2742

Laboratory Demographics

  • CLIA Code: 04D2132907
  • Facility Name: WALMART PHARMACY 10-2742
  • Facility Address: 1375 MARKET SQUARE DR
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 750-7856
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY ROBERTS
  • NPI Number: 1225055627
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2132907
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2742
Street 1375 MARKET SQUARE DR
City SPRINGDALE
State AR
ZIP 72762
Phone 479 750-7856
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type Pharmacy
Lab Director ASHLEY ROBERTS

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