17D2159018 CLIA NUMBER - WALMART PHARMACY 10-378

Laboratory Demographics

  • CLIA Code: 17D2159018
  • Facility Name: WALMART PHARMACY 10-378
  • Facility Address: 427 S ARIZONA AVE
    HOLTON, KS
    ZIP 66436
  • Facility Phone: 785 364-4619
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BOBBI MCGRATH
  • NPI Number: 1851318380
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159018
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-378
Street 427 S ARIZONA AVE
City HOLTON
State KS
ZIP 66436
Phone 785 364-4619
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 BOBBI MCGRATH

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