24D2097787 CLIA NUMBER - WALMART PHARMACY 10-1971

Laboratory Demographics

  • CLIA Code: 24D2097787
  • Facility Name: WALMART PHARMACY 10-1971
  • Facility Address: 3400 55TH STREET NW
    ROCHESTER, MN
    ZIP 55901
  • Facility Phone: 507 280-7665
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CODY RADTKE
  • NPI Number: 1295752798
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2097787
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1971
Street 3400 55TH STREET NW
City ROCHESTER
State MN
ZIP 55901
Phone 507 280-7665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Pharmacy
Lab Director CODY RADTKE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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