17D2167039 CLIA NUMBER - WALMART PHARMACY 10-4198

Laboratory Demographics

  • CLIA Code: 17D2167039
  • Facility Name: WALMART PHARMACY 10-4198
  • Facility Address: 18555 W 151ST ST
    OLATHE, KS
    ZIP 66062
  • Facility Phone: 913 764-0316
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL MAXSON
  • NPI Number: 1093732497
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2167039
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4198
Street 18555 W 151ST ST
City OLATHE
State KS
ZIP 66062
Phone 913 764-0316
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 MICHAEL MAXSON

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