17D2159125 CLIA NUMBER - WALMART PHARMACY 342

Laboratory Demographics

  • CLIA Code: 17D2159125
  • Facility Name: WALMART PHARMACY 342
  • Facility Address: 701 HOPI ST
    HIAWATHA, KS
    ZIP 66434
  • Facility Phone: 785 742-4213
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLIVIER ISHIMWE
  • NPI Number: 1760409296
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2159125
LAB Type Pharmacy
Facility Name WALMART PHARMACY 342
Street 701 HOPI ST
City HIAWATHA
State KS
ZIP 66434
Phone 785 742-4213
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 OLIVIER ISHIMWE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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