17D2159105 CLIA NUMBER - WALMART PHARMACY 10-26

Laboratory Demographics

  • CLIA Code: 17D2159105
  • Facility Name: WALMART PHARMACY 10-26
  • Facility Address: 5000 10TH AVE
    LEAVENWORTH, KS
    ZIP 66048
  • Facility Phone: 913 250-0918
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MERCY CHEPLETING
  • NPI Number: 1669600490
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 17D2159105
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-26
Street 5000 10TH AVE
City LEAVENWORTH
State KS
ZIP 66048
Phone 913 250-0918
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 MERCY CHEPLETING

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