24D2097790 CLIA NUMBER - WALMART PHARMACY 10-1999

Laboratory Demographics

  • CLIA Code: 24D2097790
  • Facility Name: WALMART PHARMACY 10-1999
  • Facility Address: 1851 BUNKER LAKE BLVD NW
    ANDOVER, MN
    ZIP 55304
  • Facility Phone: 763 354-5720
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSEY LOFTUS
  • NPI Number: 1194158618
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2097790
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1999
Street 1851 BUNKER LAKE BLVD NW
City ANDOVER
State MN
ZIP 55304
Phone 763 354-5720
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 LINDSEY LOFTUS

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