24D2153877 CLIA NUMBER - WALMART PHARMACY 10-1722

Laboratory Demographics

  • CLIA Code: 24D2153877
  • Facility Name: WALMART PHARMACY 10-1722
  • Facility Address: 1221 E MAIN STREET
    MARSHALL, MN
    ZIP 56258
  • Facility Phone: 507 532-9150
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY A. MIKKELSON
  • NPI Number: 1891712261
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2153877
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1722
Street 1221 E MAIN STREET
City MARSHALL
State MN
ZIP 56258
Phone 507 532-9150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Pharmacy
Lab Director JEFFREY A. MIKKELSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025