17D2158988 CLIA NUMBER - WALMART PHARMACY 10-4475

Laboratory Demographics

  • CLIA Code: 17D2158988
  • Facility Name: WALMART PHARMACY 10-4475
  • Facility Address: 395 N K 7 HWY
    OLATHE, KS
    ZIP 66061
  • Facility Phone: (913) 764-7165
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELODI BONA
  • NPI Number: 1174709513
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2158988
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4475
Street 395 N K 7 HWY
City OLATHE
State KS
ZIP 66061
Phone 9137647165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Pharmacy
Lab Director MELODI BONA

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This page was last updated on: 5/18/2026