25D2133203 CLIA NUMBER - WALMART PHARMACY 10-1059

Laboratory Demographics

  • CLIA Code: 25D2133203
  • Facility Name: WALMART PHARMACY 10-1059
  • Facility Address: 1309 HIGHWAY 35 S
    FOREST, MS
    ZIP 39074
  • Facility Phone: 601 469-2190
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE HODGES
  • NPI Number: 1184641599
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2133203
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1059
Street 1309 HIGHWAY 35 S
City FOREST
State MS
ZIP 39074
Phone 601 469-2190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2025
Certificate Expiration Date 7/6/2027
Facility Type Pharmacy
Lab Director STEPHANIE HODGES

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