17D2159140 CLIA NUMBER - WALMART PHARMACY #382

Laboratory Demographics

  • CLIA Code: 17D2159140
  • Facility Name: WALMART PHARMACY #382
  • Facility Address: 2101 S PRINCETON ST
    OTTAWA, KS
    ZIP 66067
  • Facility Phone: 785 242-1034
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER R. NESMITH
  • NPI Number: 1811914211
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159140
LAB Type Pharmacy
Facility Name WALMART PHARMACY #382
Street 2101 S PRINCETON ST
City OTTAWA
State KS
ZIP 66067
Phone 785 242-1034
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 CHRISTOPHER R. NESMITH

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