25D2127398 CLIA NUMBER - WALMART PHARMACY 10-1069

Laboratory Demographics

  • CLIA Code: 25D2127398
  • Facility Name: WALMART PHARMACY 10-1069
  • Facility Address: 231 EASTSIDE DR
    NEWTON, MS
    ZIP 39345
  • Facility Phone: 601 683-6117
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER KASSELMAN
  • NPI Number: 1275550683
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2127398
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1069
Street 231 EASTSIDE DR
City NEWTON
State MS
ZIP 39345
Phone 601 683-6117
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Pharmacy
Lab Director JENNIFER KASSELMAN

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