19D2129678 CLIA NUMBER - WALMART PHARMACY 10-323

Laboratory Demographics

  • CLIA Code: 19D2129678
  • Facility Name: WALMART PHARMACY 10-323
  • Facility Address: 7292 HWY #509
    MANSFIELD, LA
    ZIP 71052
  • Facility Phone: 318 872-8872
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENDAL S. KIIHAL
  • NPI Number: 1144247404
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2129678
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-323
Street 7292 HWY #509
City MANSFIELD
State LA
ZIP 71052
Phone 318 872-8872
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 KENDAL S. KIIHAL

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