17D2159132 CLIA NUMBER - WALMART PHARMACY 10-368

Laboratory Demographics

  • CLIA Code: 17D2159132
  • Facility Name: WALMART PHARMACY 10-368
  • Facility Address: 3201 NO 16TH ST
    PARSONS, KS
    ZIP 67357
  • Facility Phone: 620 421-9200
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BURL MOORE
  • NPI Number: 1740207166
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159132
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-368
Street 3201 NO 16TH ST
City PARSONS
State KS
ZIP 67357
Phone 620 421-9200
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 BURL MOORE

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