17D2159930 CLIA NUMBER - WALMART PHARMACY 5207

Laboratory Demographics

  • CLIA Code: 17D2159930
  • Facility Name: WALMART PHARMACY 5207
  • Facility Address: 9000 METCALF AVE
    OVERLAND PARK, KS
    ZIP 66212
  • Facility Phone: 913 649-4314
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DONNIE R. BOWMAN JR
  • NPI Number: 1083633069
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2159930
LAB Type Pharmacy
Facility Name WALMART PHARMACY 5207
Street 9000 METCALF AVE
City OVERLAND PARK
State KS
ZIP 66212
Phone 913 649-4314
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 DONNIE R. BOWMAN JR

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