19D2146994 CLIA NUMBER - WALMART PHARMACY #10-0075

Laboratory Demographics

  • CLIA Code: 19D2146994
  • Facility Name: WALMART PHARMACY #10-0075
  • Facility Address: 3636 MONROE HWY
    PINEVILLE, LA
    ZIP 71360
  • Facility Phone: 706 335-7818
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOTEN J. TIMOTHY
  • NPI Number: 1578010583
  • Taxonomy: 261QC1500X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 19D2146994
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-0075
Street 3636 MONROE HWY
City PINEVILLE
State LA
ZIP 71360
Phone 706 335-7818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Pharmacy
Lab Director MOTEN J. TIMOTHY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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