24D2097788 CLIA NUMBER - WALMART PHARMACY 10-4257

Laboratory Demographics

  • CLIA Code: 24D2097788
  • Facility Name: WALMART PHARMACY 10-4257
  • Facility Address: 1000 18TH AVE NORTHWEST
    AUSTIN, MN
    ZIP 55912
  • Facility Phone: 507 434-8170
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW BUTTRAM
  • NPI Number: 1336518869
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 24D2097788
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4257
Street 1000 18TH AVE NORTHWEST
City AUSTIN
State MN
ZIP 55912
Phone 507 434-8170
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 ANDREW BUTTRAM

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