24D2153953 CLIA NUMBER - WALMART PHARMACY 10-2957

Laboratory Demographics

  • CLIA Code: 24D2153953
  • Facility Name: WALMART PHARMACY 10-2957
  • Facility Address: 1583 HIGHWAY 10 W
    DETROIT LAKES, MN
    ZIP 56501
  • Facility Phone: 218 847-7225
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEX HAUKE
  • NPI Number: 1528085917
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2153953
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2957
Street 1583 HIGHWAY 10 W
City DETROIT LAKES
State MN
ZIP 56501
Phone 218 847-7225
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 ALEX HAUKE

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