17D2159089 CLIA NUMBER - WALMART NEIGHBORHOOD PHARMACY 5791

Laboratory Demographics

  • CLIA Code: 17D2159089
  • Facility Name: WALMART NEIGHBORHOOD PHARMACY 5791
  • Facility Address: 1011 EAST CENTENNIAL DRIVE
    PITTSBURG, KS
    ZIP 66762
  • Facility Phone: 620 308-7110
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELSEY S. CARTER
  • NPI Number: 1437230802
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 17D2159089
LAB Type Pharmacy
Facility Name WALMART NEIGHBORHOOD PHARMACY 5791
Street 1011 EAST CENTENNIAL DRIVE
City PITTSBURG
State KS
ZIP 66762
Phone 620 308-7110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Pharmacy
Lab Director KELSEY S. CARTER

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