24D2154637 CLIA NUMBER - WALMART PHARMACY 10-4246

Laboratory Demographics

  • CLIA Code: 24D2154637
  • Facility Name: WALMART PHARMACY 10-4246
  • Facility Address: 100 JUNIPER AVE
    WADENA, MN
    ZIP 56482
  • Facility Phone: 218 631-1723
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANELLE VANDERMAY
  • NPI Number: 1902961048
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2154637
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4246
Street 100 JUNIPER AVE
City WADENA
State MN
ZIP 56482
Phone 218 631-1723
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 DANELLE VANDERMAY

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This page was last updated on: 6/4/2025