07D2297501 CLIA NUMBER - WALMART # 2719

Laboratory Demographics

  • CLIA Code: 07D2297501
  • Facility Name: WALMART # 2719
  • Facility Address: 1400 FARMINGTON AVE
    BRISTOL, CT
    ZIP 06010
  • Facility Phone: 479 371-2777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATRINA SKROUPA
  • NPI Number: 1043391055
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 07D2297501
LAB Type Pharmacy
Facility Name WALMART # 2719
Street 1400 FARMINGTON AVE
City BRISTOL
State CT
ZIP 06010
Phone 479 371-2777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Pharmacy
Lab Director KATRINA SKROUPA

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