24D2154300 CLIA NUMBER - WALMART PHARMACY 10-3102

Laboratory Demographics

  • CLIA Code: 24D2154300
  • Facility Name: WALMART PHARMACY 10-3102
  • Facility Address: 300 21ST AVE N
    PRINCETON, MN
    ZIP 55371
  • Facility Phone: 763 389-1148
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL LAWRENCE
  • NPI Number: 1043554504
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2154300
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3102
Street 300 21ST AVE N
City PRINCETON
State MN
ZIP 55371
Phone 763 389-1148
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Pharmacy
Lab Director MICHAEL LAWRENCE

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