25D2139464 CLIA NUMBER - WALMART PHARMACY 10-0699

Laboratory Demographics

  • CLIA Code: 25D2139464
  • Facility Name: WALMART PHARMACY 10-0699
  • Facility Address: 2530 JACKSON AVENUE WEST
    OXFORD, MS
    ZIP 38655
  • Facility Phone: 662 236-5905
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH THOMAS
  • NPI Number: 1457378861
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2139464
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0699
Street 2530 JACKSON AVENUE WEST
City OXFORD
State MS
ZIP 38655
Phone 662 236-5905
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Pharmacy
Lab Director ELIZABETH THOMAS

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