17D2159095 CLIA NUMBER - WALMART PHARMACY 10-5855

Laboratory Demographics

  • CLIA Code: 17D2159095
  • Facility Name: WALMART PHARMACY 10-5855
  • Facility Address: 10550 W CENTRAL AVE
    WICHITA, KS
    ZIP 67212
  • Facility Phone: 316 448-4257
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATY SMITH
  • NPI Number: 1699069765
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159095
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5855
Street 10550 W CENTRAL AVE
City WICHITA
State KS
ZIP 67212
Phone 316 448-4257
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 KATY SMITH

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