25D2127439 CLIA NUMBER - WALMART PHARMACY 10-1192

Laboratory Demographics

  • CLIA Code: 25D2127439
  • Facility Name: WALMART PHARMACY 10-1192
  • Facility Address: 1625 SIMPSON HWY 49
    MAGEE, MS
    ZIP 39111
  • Facility Phone: 601 849-3228
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY BERNAL
  • NPI Number: 1447277850
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2127439
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1192
Street 1625 SIMPSON HWY 49
City MAGEE
State MS
ZIP 39111
Phone 601 849-3228
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 TIMOTHY BERNAL

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