16D2143365 CLIA NUMBER - WALMART PHARMACY 10-4606

Laboratory Demographics

  • CLIA Code: 16D2143365
  • Facility Name: WALMART PHARMACY 10-4606
  • Facility Address: 2400 COLLEGE DRIVE
    OSCEOLA, IA
    ZIP 50213
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYLE STARA
  • NPI Number: 1720264179
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2143365
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4606
Street 2400 COLLEGE DRIVE
City OSCEOLA
State IA
ZIP 50213
Phone 479 277-2374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2024
Certificate Expiration Date 1/28/2026
Facility Type Pharmacy
Lab Director KYLE STARA

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