04D2139510 CLIA NUMBER - WALMART PHARMACY 10-6971

Laboratory Demographics

  • CLIA Code: 04D2139510
  • Facility Name: WALMART PHARMACY 10-6971
  • Facility Address: 240 SLACK STREET
    PEA RIDGE, AR
    ZIP 72751
  • Facility Phone: 479 451-9008
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BENJAMIN SCHNEIDER
  • NPI Number: 1417374794
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2139510
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6971
Street 240 SLACK STREET
City PEA RIDGE
State AR
ZIP 72751
Phone 479 451-9008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director BENJAMIN SCHNEIDER

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