25D2117451 CLIA NUMBER - WALMART PHARMACY 10-5776

Laboratory Demographics

  • CLIA Code: 25D2117451
  • Facility Name: WALMART PHARMACY 10-5776
  • Facility Address: 6412 WASHINGTON AVENUE
    OCEAN SPRINGS, MS
    ZIP 39564
  • Facility Phone: 228 334-3053
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HOANG KELLY-THANH
  • NPI Number: 1629526694
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2117451
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5776
Street 6412 WASHINGTON AVENUE
City OCEAN SPRINGS
State MS
ZIP 39564
Phone 228 334-3053
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Pharmacy
Lab Director HOANG KELLY-THANH

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