24D2097707 CLIA NUMBER - WALMART PHARMACY 10-1473

Laboratory Demographics

  • CLIA Code: 24D2097707
  • Facility Name: WALMART PHARMACY 10-1473
  • Facility Address: 1881 EAST MADISON AVE
    MANKATO, MN
    ZIP 56001
  • Facility Phone: 507 625-1660
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KILEY HYLAND
  • NPI Number: 1538186911
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2097707
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1473
Street 1881 EAST MADISON AVE
City MANKATO
State MN
ZIP 56001
Phone 507 625-1660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Pharmacy
Lab Director KILEY HYLAND

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