17D2159925 CLIA NUMBER - WALMART PHARMACY 10-1282

Laboratory Demographics

  • CLIA Code: 17D2159925
  • Facility Name: WALMART PHARMACY 10-1282
  • Facility Address: 140 E COLLEGE DR
    CONCORDIA, KS
    ZIP 66901
  • Facility Phone: 785 243-2805
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON BRANFORT
  • NPI Number: 1467479873
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2159925
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1282
Street 140 E COLLEGE DR
City CONCORDIA
State KS
ZIP 66901
Phone 785 243-2805
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2024
Certificate Expiration Date 12/30/2026
Facility Type Pharmacy
Lab Director JASON BRANFORT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025