16D2130640 CLIA NUMBER - WALMART PHARMACY 10-0647

Laboratory Demographics

  • CLIA Code: 16D2130640
  • Facility Name: WALMART PHARMACY 10-0647
  • Facility Address: 415 INDUSTRIAL AVENUE
    GRINNELL, IA
    ZIP 50112
  • Facility Phone: 641 236-6333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALISON RICHARDS
  • NPI Number: 1831116326
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2130640
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0647
Street 415 INDUSTRIAL AVENUE
City GRINNELL
State IA
ZIP 50112
Phone 641 236-6333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2023
Certificate Expiration Date 5/14/2025
Facility Type Pharmacy
Lab Director ALISON RICHARDS

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This page was last updated on: 3/20/2025