17D2164799 CLIA NUMBER - WALMART PHARMACY 10-799

Laboratory Demographics

  • CLIA Code: 17D2164799
  • Facility Name: WALMART PHARMACY 10-799
  • Facility Address: 250 E TUCKER RD
    LIBERAL, KS
    ZIP 67901
  • Facility Phone: 620 626-4240
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TERI HARP
  • NPI Number: 1639196033
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2164799
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-799
Street 250 E TUCKER RD
City LIBERAL
State KS
ZIP 67901
Phone 620 626-4240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Pharmacy
Lab Director TERI HARP

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