04D2139520 CLIA NUMBER - WALMART PHARMACY 10-3230

Laboratory Demographics

  • CLIA Code: 04D2139520
  • Facility Name: WALMART PHARMACY 10-3230
  • Facility Address: 400 BRYANT AVE
    BRYANT, AR
    ZIP 72022
  • Facility Phone: 501 847-4615
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. MARY E. JAMES
  • NPI Number: 1861419269
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2139520
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3230
Street 400 BRYANT AVE
City BRYANT
State AR
ZIP 72022
Phone 501 847-4615
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 MS. MARY E. JAMES

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This page was last updated on: 6/4/2025