17D2159926 CLIA NUMBER - WALMART PHARMACY 10-6392

Laboratory Demographics

  • CLIA Code: 17D2159926
  • Facility Name: WALMART PHARMACY 10-6392
  • Facility Address: 2630 SE CALIFORNIA AVENUE
    TOPEKA, KS
    ZIP 66605
  • Facility Phone: 785 379-2344
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMBOUE DEFFO
  • NPI Number: 1104226307
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159926
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6392
Street 2630 SE CALIFORNIA AVENUE
City TOPEKA
State KS
ZIP 66605
Phone 785 379-2344
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 TAMBOUE DEFFO

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