23D2149496 CLIA NUMBER - WALMART PHARMACY 10-3632

Laboratory Demographics

  • CLIA Code: 23D2149496
  • Facility Name: WALMART PHARMACY 10-3632
  • Facility Address: 655 W SANILAC ROAD
    SANDUSKY, MI
    ZIP 48471
  • Facility Phone: 810 648-4247
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN DIECKMANN
  • NPI Number: 1184641557
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2149496
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3632
Street 655 W SANILAC ROAD
City SANDUSKY
State MI
ZIP 48471
Phone 810 648-4247
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 KEVIN DIECKMANN

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