23D2129637 CLIA NUMBER - WALMART PHARMACY 10-2192

Laboratory Demographics

  • CLIA Code: 23D2129637
  • Facility Name: WALMART PHARMACY 10-2192
  • Facility Address: 995 RAZORBACK DRIVE
    HOUGHTON, MI
    ZIP 49931
  • Facility Phone: 906 482-5988
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATHEE DE FALLA
  • NPI Number: 1902823115
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2129637
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2192
Street 995 RAZORBACK DRIVE
City HOUGHTON
State MI
ZIP 49931
Phone 906 482-5988
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 KATHEE DE FALLA

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