17D2159023 CLIA NUMBER - WALMART PHARMACY #1054

Laboratory Demographics

  • CLIA Code: 17D2159023
  • Facility Name: WALMART PHARMACY #1054
  • Facility Address: 1920 US-73
    ATCHISON, KS
    ZIP 66002
  • Facility Phone: 913 367-6142
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA CAIN
  • NPI Number: 1043237571
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159023
LAB Type Pharmacy
Facility Name WALMART PHARMACY #1054
Street 1920 US-73
City ATCHISON
State KS
ZIP 66002
Phone 913 367-6142
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 AMANDA CAIN

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