16D2128863 CLIA NUMBER - WALMART PHARMACY 10-1683

Laboratory Demographics

  • CLIA Code: 16D2128863
  • Facility Name: WALMART PHARMACY 10-1683
  • Facility Address: 705 S FREMONT STREET
    SHENANDOAH, IA
    ZIP 51601
  • Facility Phone: 712 246-4033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JANA K. FLETCHER
  • NPI Number: 1093732471
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2128863
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1683
Street 705 S FREMONT STREET
City SHENANDOAH
State IA
ZIP 51601
Phone 712 246-4033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Pharmacy
Lab Director JANA K. FLETCHER

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