24D2154302 CLIA NUMBER - WALMART PHARMACY 10-3088

Laboratory Demographics

  • CLIA Code: 24D2154302
  • Facility Name: WALMART PHARMACY 10-3088
  • Facility Address: 3601 2ND STREET SOUTH
    SAINT CLOUD, MN
    ZIP 56301
  • Facility Phone: 320 345-9821
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMED FARAH
  • NPI Number: 1487902441
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2154302
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3088
Street 3601 2ND STREET SOUTH
City SAINT CLOUD
State MN
ZIP 56301
Phone 320 345-9821
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 AHMED FARAH

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