07D2297509 CLIA NUMBER - WALMART #2954

Laboratory Demographics

  • CLIA Code: 07D2297509
  • Facility Name: WALMART #2954
  • Facility Address: 650 MAIN AVE
    NORWALK, CT
    ZIP 06851
  • Facility Phone: 479 371-2777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID PRUSSACK
  • NPI Number: 1982621272
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2297509
LAB Type Pharmacy
Facility Name WALMART #2954
Street 650 MAIN AVE
City NORWALK
State CT
ZIP 06851
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 DAVID PRUSSACK

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