07D2297504 CLIA NUMBER - WALMART # 2897

Laboratory Demographics

  • CLIA Code: 07D2297504
  • Facility Name: WALMART # 2897
  • Facility Address: 235 QUEEN ST
    SOUTHINGTON, CT
    ZIP 06489
  • Facility Phone: 479 371-2777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VINCENT MILO
  • NPI Number: 1073602033
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 07D2297504
LAB Type Pharmacy
Facility Name WALMART # 2897
Street 235 QUEEN ST
City SOUTHINGTON
State CT
ZIP 06489
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 VINCENT MILO

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