25D2127876 CLIA NUMBER - WALMART PHARMACY 10-0205

Laboratory Demographics

  • CLIA Code: 25D2127876
  • Facility Name: WALMART PHARMACY 10-0205
  • Facility Address: 1002 W BEACON ST
    PHILADELPHIA, MS
    ZIP 39350
  • Facility Phone: 601 656-5310
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BETH LONG
  • NPI Number: 1790702199
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2127876
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0205
Street 1002 W BEACON ST
City PHILADELPHIA
State MS
ZIP 39350
Phone 601 656-5310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Pharmacy
Lab Director BETH LONG

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