24D2174219 CLIA NUMBER - WALMART PHARMACY #10-1632

Laboratory Demographics

  • CLIA Code: 24D2174219
  • Facility Name: WALMART PHARMACY #10-1632
  • Facility Address: 4611 STATE HIGHWAY 29 S
    ALEXANDRIA, MN
    ZIP 56308
  • Facility Phone: 320 762-2850
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY MEICHSNER
  • NPI Number: 1386661874
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2174219
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1632
Street 4611 STATE HIGHWAY 29 S
City ALEXANDRIA
State MN
ZIP 56308
Phone 320 762-2850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Pharmacy
Lab Director BRADLEY MEICHSNER

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