16D2143682 CLIA NUMBER - WALMART PHARMACY 10-1528

Laboratory Demographics

  • CLIA Code: 16D2143682
  • Facility Name: WALMART PHARMACY 10-1528
  • Facility Address: 2645 BLAIRS FERRY RD NE
    CEDAR RAPIDS, IA
    ZIP 52411
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRATIK AMIN
  • NPI Number: 1730106113
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2143682
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1528
Street 2645 BLAIRS FERRY RD NE
City CEDAR RAPIDS
State IA
ZIP 52411
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 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Pharmacy
Lab Director PRATIK AMIN

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This page was last updated on: 6/4/2025