24D2097967 CLIA NUMBER - WALMART PHARMACY 10-2820

Laboratory Demographics

  • CLIA Code: 24D2097967
  • Facility Name: WALMART PHARMACY 10-2820
  • Facility Address: 1055 RYANS RD
    WORTHINGTON, MN
    ZIP 56187
  • Facility Phone: 507 376-4080
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL HARLOW
  • NPI Number: 1447277835
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2097967
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2820
Street 1055 RYANS RD
City WORTHINGTON
State MN
ZIP 56187
Phone 507 376-4080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2025
Certificate Expiration Date 6/27/2027
Facility Type Pharmacy
Lab Director MICHAEL HARLOW

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