25D2139488 CLIA NUMBER - WALMART PHARMACY 10-0347

Laboratory Demographics

  • CLIA Code: 25D2139488
  • Facility Name: WALMART PHARMACY 10-0347
  • Facility Address: 633 HIGHWAY 82 WEST
    INDIANOLA, MS
    ZIP 38751
  • Facility Phone: 662 887-3788
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVEN A. MCKAY
  • NPI Number: 1700803111
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2139488
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0347
Street 633 HIGHWAY 82 WEST
City INDIANOLA
State MS
ZIP 38751
Phone 662 887-3788
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 STEVEN A. MCKAY

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