17D2159107 CLIA NUMBER - WALMART PHARMACY 10-39

Laboratory Demographics

  • CLIA Code: 17D2159107
  • Facility Name: WALMART PHARMACY 10-39
  • Facility Address: 2500 S MAIN ST
    FORT SCOTT, KS
    ZIP 66701
  • Facility Phone: 620 223-5051
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELE DUNKESON
  • NPI Number: 1831116250
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159107
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-39
Street 2500 S MAIN ST
City FORT SCOTT
State KS
ZIP 66701
Phone 620 223-5051
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 MICHELE DUNKESON

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