23D2129644 CLIA NUMBER - WALMART PHARMACY 10-2434

Laboratory Demographics

  • CLIA Code: 23D2129644
  • Facility Name: WALMART PHARMACY 10-2434
  • Facility Address: 1920 S STEPHENSON AVENUE
    IRON MOUNTAIN, MI
    ZIP 49801
  • Facility Phone: 906 779-7185
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEIGH DIGHERA
  • NPI Number: 1780602110
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2129644
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2434
Street 1920 S STEPHENSON AVENUE
City IRON MOUNTAIN
State MI
ZIP 49801
Phone 906 779-7185
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 LEIGH DIGHERA

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