16D2130641 CLIA NUMBER - WALMART PHARMACY 10-0797

Laboratory Demographics

  • CLIA Code: 16D2130641
  • Facility Name: WALMART PHARMACY 10-0797
  • Facility Address: 324 W AGENCY RD
    WEST BURLINGTON, IA
    ZIP 52655
  • Facility Phone: 319 753-2269
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIN TRAN
  • NPI Number: 1932126315
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2130641
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0797
Street 324 W AGENCY RD
City WEST BURLINGTON
State IA
ZIP 52655
Phone 319 753-2269
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Pharmacy
Lab Director TIN TRAN

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