24D2097903 CLIA NUMBER - WALMART PHARMACY 10-2087

Laboratory Demographics

  • CLIA Code: 24D2097903
  • Facility Name: WALMART PHARMACY 10-2087
  • Facility Address: 850 EAST COUNTY ROAD E
    VADNAIS HEIGHTS, MN
    ZIP 55127
  • Facility Phone: 651 486-7005
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN J. RECHTIENE
  • NPI Number: 1104843606
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2097903
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2087
Street 850 EAST COUNTY ROAD E
City VADNAIS HEIGHTS
State MN
ZIP 55127
Phone 651 486-7005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Pharmacy
Lab Director JONATHAN J. RECHTIENE

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