25D2120180 CLIA NUMBER - WALMART PHARMACY 10-2846

Laboratory Demographics

  • CLIA Code: 25D2120180
  • Facility Name: WALMART PHARMACY 10-2846
  • Facility Address: 7950 CRAFT GOODMAN FRONTAGE ROAD
    OLIVE BRANCH, MS
    ZIP 38654
  • Facility Phone: 479 258-2243
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRITTNEY WALTERS
  • NPI Number: 1639197163
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2120180
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2846
Street 7950 CRAFT GOODMAN FRONTAGE ROAD
City OLIVE BRANCH
State MS
ZIP 38654
Phone 479 258-2243
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Pharmacy
Lab Director BRITTNEY WALTERS

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