16D2130649 CLIA NUMBER - WALMART PHARMACY 10-1285

Laboratory Demographics

  • CLIA Code: 16D2130649
  • Facility Name: WALMART PHARMACY 10-1285
  • Facility Address: 1940 VENTURE DR
    OTTUMWA, IA
    ZIP 52501
  • Facility Phone: 641 683-1357
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN JONES
  • NPI Number: 1104843580
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2130649
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1285
Street 1940 VENTURE DR
City OTTUMWA
State IA
ZIP 52501
Phone 641 683-1357
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 JONATHAN JONES

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