17D2167043 CLIA NUMBER - WALMART PHARMACY 3283

Laboratory Demographics

  • CLIA Code: 17D2167043
  • Facility Name: WALMART PHARMACY 3283
  • Facility Address: 10600 W 121ST ST NORTH
    WICHITA, KS
    ZIP 67205
  • Facility Phone: 316 729-5914
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSEY R. MOSER
  • NPI Number: 1194742510
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2167043
LAB Type Pharmacy
Facility Name WALMART PHARMACY 3283
Street 10600 W 121ST ST NORTH
City WICHITA
State KS
ZIP 67205
Phone 316 729-5914
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 LINDSEY R. MOSER

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