24D2098071 CLIA NUMBER - WALMART PHARMACY 10-5992

Laboratory Demographics

  • CLIA Code: 24D2098071
  • Facility Name: WALMART PHARMACY 10-5992
  • Facility Address: 20710 KEOKUK AVE
    LAKEVILLE, MN
    ZIP 55044
  • Facility Phone: 612 354-5934
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANGEETHA NAIR
  • NPI Number: 1215285408
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2098071
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5992
Street 20710 KEOKUK AVE
City LAKEVILLE
State MN
ZIP 55044
Phone 612 354-5934
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Pharmacy
Lab Director SANGEETHA NAIR

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