04D2140343 CLIA NUMBER - WALMART PHARMACY 10-0083

Laboratory Demographics

  • CLIA Code: 04D2140343
  • Facility Name: WALMART PHARMACY 10-0083
  • Facility Address: 60 79 BYPASS N
    MAGNOLIA, AR
    ZIP 71753
  • Facility Phone: 870 234-5421
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDA R. WARNER
  • NPI Number: 1811914302
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2140343
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0083
Street 60 79 BYPASS N
City MAGNOLIA
State AR
ZIP 71753
Phone 870 234-5421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Pharmacy
Lab Director LINDA R. WARNER

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