24D2097907 CLIA NUMBER - WALMART PHARMACY 10-2198

Laboratory Demographics

  • CLIA Code: 24D2097907
  • Facility Name: WALMART PHARMACY 10-2198
  • Facility Address: 700 AMERICAN BLVD E
    BLOOMINGTON, MN
    ZIP 55420
  • Facility Phone: 952 854-8850
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN SISK
  • NPI Number: 1730316647
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2097907
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2198
Street 700 AMERICAN BLVD E
City BLOOMINGTON
State MN
ZIP 55420
Phone 952 854-8850
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 RYAN SISK

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