17D2159135 CLIA NUMBER - WALMART PHARMACY 10-72

Laboratory Demographics

  • CLIA Code: 17D2159135
  • Facility Name: WALMART PHARMACY 10-72
  • Facility Address: 2710 N BROADWAY ST
    PITTSBURG, KS
    ZIP 66762
  • Facility Phone: 620 231-0756
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY D. MCGOWN
  • NPI Number: 1194742502
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159135
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-72
Street 2710 N BROADWAY ST
City PITTSBURG
State KS
ZIP 66762
Phone 620 231-0756
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 AMY D. MCGOWN

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