24D2097969 CLIA NUMBER - WALMART PHARMACY 10-3364

Laboratory Demographics

  • CLIA Code: 24D2097969
  • Facility Name: WALMART PHARMACY 10-3364
  • Facility Address: 1644 ROBERT ST S
    WEST SAINT PAUL, MN
    ZIP 55118
  • Facility Phone: 651 453-9671
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARC LANDES
  • NPI Number: 1891712295
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2097969
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3364
Street 1644 ROBERT ST S
City WEST SAINT PAUL
State MN
ZIP 55118
Phone 651 453-9671
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 MARC LANDES

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