17D2159629 CLIA NUMBER - WALMART PHARMACY 10-4321

Laboratory Demographics

  • CLIA Code: 17D2159629
  • Facility Name: WALMART PHARMACY 10-4321
  • Facility Address: 5475 N MERIDIAN
    WICHITA, KS
    ZIP 67204
  • Facility Phone: 316 831-9057
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHEILA EARHART
  • NPI Number: 1487836110
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159629
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4321
Street 5475 N MERIDIAN
City WICHITA
State KS
ZIP 67204
Phone 316 831-9057
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 SHEILA EARHART

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