17D2159141 CLIA NUMBER - WALMART PHARMACY 10-484

Laboratory Demographics

  • CLIA Code: 17D2159141
  • Facility Name: WALMART PHARMACY 10-484
  • Facility Address: 3300 IOWA ST
    LAWRENCE, KS
    ZIP 66046
  • Facility Phone: 785 842-0177
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAHALA BRANSON
  • NPI Number: 1548287931
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159141
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-484
Street 3300 IOWA ST
City LAWRENCE
State KS
ZIP 66046
Phone 785 842-0177
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 MAHALA BRANSON

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