24D2153933 CLIA NUMBER - WALMART PHARMACY 10-1855

Laboratory Demographics

  • CLIA Code: 24D2153933
  • Facility Name: WALMART PHARMACY 10-1855
  • Facility Address: 12195 SINGLETREE LANE
    EDEN PRAIRIE, MN
    ZIP 55344
  • Facility Phone: 952 829-9030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THONY THAO
  • NPI Number: 1184641565
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2153933
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1855
Street 12195 SINGLETREE LANE
City EDEN PRAIRIE
State MN
ZIP 55344
Phone 952 829-9030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2024
Certificate Expiration Date 9/3/2026
Facility Type Pharmacy
Lab Director THONY THAO

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