19D2140266 CLIA NUMBER - WALMART PHARMACY 10-428

Laboratory Demographics

  • CLIA Code: 19D2140266
  • Facility Name: WALMART PHARMACY 10-428
  • Facility Address: 5801 MAIN ST
    ZACHARY, LA
    ZIP 70791
  • Facility Phone: 225 654-3087
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GLENN S. WARCISKI
  • NPI Number: 1801814397
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2140266
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-428
Street 5801 MAIN ST
City ZACHARY
State LA
ZIP 70791
Phone 225 654-3087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Pharmacy
Lab Director GLENN S. WARCISKI

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