17D2123282 CLIA NUMBER - WALMART PHARMACY 10-794

Laboratory Demographics

  • CLIA Code: 17D2123282
  • Facility Name: WALMART PHARMACY 10-794
  • Facility Address: 1905 E 17TH AVE
    HUTCHINSON, KS
    ZIP 67501
  • Facility Phone: 620 669-0125
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHAUN WATTS
  • NPI Number: 1548287949
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2123282
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-794
Street 1905 E 17TH AVE
City HUTCHINSON
State KS
ZIP 67501
Phone 620 669-0125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director SHAUN WATTS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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