17D2159628 CLIA NUMBER - WALMART PHARMACY 10-2562

Laboratory Demographics

  • CLIA Code: 17D2159628
  • Facility Name: WALMART PHARMACY 10-2562
  • Facility Address: 2160 COMMERCE ROAD
    GOODLAND, KS
    ZIP 67735
  • Facility Phone: 706 335-7818
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TESS E. HAND
  • NPI Number: 1093733529
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159628
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2562
Street 2160 COMMERCE ROAD
City GOODLAND
State KS
ZIP 67735
Phone 706 335-7818
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 TESS E. HAND

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