24D2097745 CLIA NUMBER - WALMART PHARMACY 10-1952

Laboratory Demographics

  • CLIA Code: 24D2097745
  • Facility Name: WALMART PHARMACY 10-1952
  • Facility Address: 8450 UNIVERSITY AVE NE
    FRIDLEY, MN
    ZIP 55432
  • Facility Phone: 763 780-9500
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES E. KLUSSMAN
  • NPI Number: 1083631469
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2097745
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1952
Street 8450 UNIVERSITY AVE NE
City FRIDLEY
State MN
ZIP 55432
Phone 763 780-9500
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 JAMES E. KLUSSMAN

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