19D2129647 CLIA NUMBER - WALMART PHARMACY 10-149

Laboratory Demographics

  • CLIA Code: 19D2129647
  • Facility Name: WALMART PHARMACY 10-149
  • Facility Address: 184 OLD WINNFIELD RD
    JONESBORO, LA
    ZIP 71251
  • Facility Phone: 318 259-6694
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA N. HOTARD
  • NPI Number: 1336166693
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2129647
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-149
Street 184 OLD WINNFIELD RD
City JONESBORO
State LA
ZIP 71251
Phone 318 259-6694
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2025
Certificate Expiration Date 4/23/2027
Facility Type Pharmacy
Lab Director ANGELA N. HOTARD

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