17D2167033 CLIA NUMBER - WALMART PHARMACY 10-1099

Laboratory Demographics

  • CLIA Code: 17D2167033
  • Facility Name: WALMART PHARMACY 10-1099
  • Facility Address: 501 E PAWNEE ST
    WICHITA, KS
    ZIP 67211
  • Facility Phone: 316 267-4230
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JINNI A. BLISS
  • NPI Number: 1376560789
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2167033
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1099
Street 501 E PAWNEE ST
City WICHITA
State KS
ZIP 67211
Phone 316 267-4230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Pharmacy
Lab Director JINNI A. BLISS

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: 9/29/2025