04D2139452 CLIA NUMBER - WALMART PHARMACY 10-0141

Laboratory Demographics

  • CLIA Code: 04D2139452
  • Facility Name: WALMART PHARMACY 10-0141
  • Facility Address: 8301 ROGERS AVE
    FORT SMITH, AR
    ZIP 72903
  • Facility Phone: 479 452-3695
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. BENJAMIN KING
  • NPI Number: 1881611267
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2139452
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0141
Street 8301 ROGERS AVE
City FORT SMITH
State AR
ZIP 72903
Phone 479 452-3695
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 MR. BENJAMIN KING

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