23D2149473 CLIA NUMBER - WALMART PHARMACY 10-2619

Laboratory Demographics

  • CLIA Code: 23D2149473
  • Facility Name: WALMART PHARMACY 10-2619
  • Facility Address: 910 JOE MANN BLVD
    MIDLAND, MI
    ZIP 48642
  • Facility Phone: 989 835-6364
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELISSA OUSTERHOUT
  • NPI Number: 1477570695
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149473
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2619
Street 910 JOE MANN BLVD
City MIDLAND
State MI
ZIP 48642
Phone 989 835-6364
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Pharmacy
Lab Director MELISSA OUSTERHOUT

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