04D2139462 CLIA NUMBER - WALMART PHARMACY 10-0209

Laboratory Demographics

  • CLIA Code: 04D2139462
  • Facility Name: WALMART PHARMACY 10-0209
  • Facility Address: 1516 N 18TH ST
    OZARK, AR
    ZIP 72949
  • Facility Phone: 479 667-4448
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMILY RICHARDSON
  • NPI Number: 1326065715
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2139462
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0209
Street 1516 N 18TH ST
City OZARK
State AR
ZIP 72949
Phone 479 667-4448
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 EMILY RICHARDSON

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