04D2139531 CLIA NUMBER - WALMART PHARMACY 10-0062

Laboratory Demographics

  • CLIA Code: 04D2139531
  • Facility Name: WALMART PHARMACY 10-0062
  • Facility Address: 2700 E HWY 18
    BLYTHEVILLE, AR
    ZIP 72315
  • Facility Phone: 870 763-1013
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. EMILY SANDERS
  • NPI Number: 1245313725
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 04D2139531
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0062
Street 2700 E HWY 18
City BLYTHEVILLE
State AR
ZIP 72315
Phone 870 763-1013
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 MR. EMILY SANDERS

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