24D2098072 CLIA NUMBER - WALMART PHARMACY 10-5977

Laboratory Demographics

  • CLIA Code: 24D2098072
  • Facility Name: WALMART PHARMACY 10-5977
  • Facility Address: 12200 RIVER RIDGE BLVD
    BURNSVILLE, MN
    ZIP 55337
  • Facility Phone: 952 356-3336
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATHERINE KING
  • NPI Number: 1053669085
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2098072
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5977
Street 12200 RIVER RIDGE BLVD
City BURNSVILLE
State MN
ZIP 55337
Phone 952 356-3336
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 KATHERINE KING

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