25D2127442 CLIA NUMBER - WALMART PHARMACY 10-6323

Laboratory Demographics

  • CLIA Code: 25D2127442
  • Facility Name: WALMART PHARMACY 10-6323
  • Facility Address: 11333 HWY 49
    GULFPORT, MS
    ZIP 39503
  • Facility Phone: 228 284-6113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WYATT M. CONNELLEY
  • NPI Number: 1215321716
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2127442
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6323
Street 11333 HWY 49
City GULFPORT
State MS
ZIP 39503
Phone 228 284-6113
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 WYATT M. CONNELLEY

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