04D2139523 CLIA NUMBER - WALMART PHARMACY 10-0007

Laboratory Demographics

  • CLIA Code: 04D2139523
  • Facility Name: WALMART PHARMACY 10-0007
  • Facility Address: 9053 HWY 107
    SHERWOOD, AR
    ZIP 72120
  • Facility Phone: 501 753-6454
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY T. ROGERS
  • NPI Number: 1356726558
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 04D2139523
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0007
Street 9053 HWY 107
City SHERWOOD
State AR
ZIP 72120
Phone 501 753-6454
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 JEFFREY T. ROGERS

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