16D2144851 CLIA NUMBER - WALMART PHARMACY 10-1625

Laboratory Demographics

  • CLIA Code: 16D2144851
  • Facility Name: WALMART PHARMACY 10-1625
  • Facility Address: 1111 HOLTON DR
    LE MARS, IA
    ZIP 51031
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMED ELMASSRY
  • NPI Number: 1285651661
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2144851
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1625
Street 1111 HOLTON DR
City LE MARS
State IA
ZIP 51031
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 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Pharmacy
Lab Director AHMED ELMASSRY

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