04D2138922 CLIA NUMBER - WALMART PHARMACY 10-0124

Laboratory Demographics

  • CLIA Code: 04D2138922
  • Facility Name: WALMART PHARMACY 10-0124
  • Facility Address: 8801 BASELINE RD
    LITTLE ROCK, AR
    ZIP 72209
  • Facility Phone: 501 565-1164
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CATHERINE SUKUP
  • NPI Number: 1508883901
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2138922
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0124
Street 8801 BASELINE RD
City LITTLE ROCK
State AR
ZIP 72209
Phone 501 565-1164
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Pharmacy
Lab Director CATHERINE SUKUP

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