04D2140800 CLIA NUMBER - WALMART PHARMACY 10-0336

Laboratory Demographics

  • CLIA Code: 04D2140800
  • Facility Name: WALMART PHARMACY 10-0336
  • Facility Address: 1308 S ROCK ST
    SHERIDAN, AR
    ZIP 72150
  • Facility Phone: 870 942-5045
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LESLEY STAMPER
  • NPI Number: 1053338459
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2140800
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0336
Street 1308 S ROCK ST
City SHERIDAN
State AR
ZIP 72150
Phone 870 942-5045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Pharmacy
Lab Director LESLEY STAMPER

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