24D2154606 CLIA NUMBER - WALMART PHARMACY 10-4253

Laboratory Demographics

  • CLIA Code: 24D2154606
  • Facility Name: WALMART PHARMACY 10-4253
  • Facility Address: 205 12TH STREET S
    SAUK CENTRE, MN
    ZIP 56378
  • Facility Phone: 320 352-7943
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOLLI JANNETTE
  • NPI Number: 1922122365
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2154606
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4253
Street 205 12TH STREET S
City SAUK CENTRE
State MN
ZIP 56378
Phone 320 352-7943
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Pharmacy
Lab Director MOLLI JANNETTE

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