17D2159627 CLIA NUMBER - WALMART PHARMACY 10-1599

Laboratory Demographics

  • CLIA Code: 17D2159627
  • Facility Name: WALMART PHARMACY 10-1599
  • Facility Address: 11701 METCALF AVE
    OVERLAND PARK, KS
    ZIP 66210
  • Facility Phone: 913 338-1849
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANH PHAM
  • NPI Number: 1376560771
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159627
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1599
Street 11701 METCALF AVE
City OVERLAND PARK
State KS
ZIP 66210
Phone 913 338-1849
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Pharmacy
Lab Director ANH PHAM

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