24D2153853 CLIA NUMBER - WALMART PHARMACY 10-1657

Laboratory Demographics

  • CLIA Code: 24D2153853
  • Facility Name: WALMART PHARMACY 10-1657
  • Facility Address: 150 WESTERN AVE NW
    FARIBAULT, MN
    ZIP 55021
  • Facility Phone: 507 332-0084
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADAM PRICE
  • NPI Number: 1447277827
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2153853
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1657
Street 150 WESTERN AVE NW
City FARIBAULT
State MN
ZIP 55021
Phone 507 332-0084
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Pharmacy
Lab Director ADAM PRICE

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