04D2139427 CLIA NUMBER - WALMART PHARMACY 10-0070

Laboratory Demographics

  • CLIA Code: 04D2139427
  • Facility Name: WALMART PHARMACY 10-0070
  • Facility Address: 798 W SERVICE RD
    WEST MEMPHIS, AR
    ZIP 72301
  • Facility Phone: 870 735-2324
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. ALLISON NITA
  • NPI Number: 1316020845
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 04D2139427
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0070
Street 798 W SERVICE RD
City WEST MEMPHIS
State AR
ZIP 72301
Phone 870 735-2324
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Pharmacy
Lab Director MS. ALLISON NITA

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