25D2139499 CLIA NUMBER - WALMART PHARMACY 10-0716

Laboratory Demographics

  • CLIA Code: 25D2139499
  • Facility Name: WALMART PHARMACY 10-0716
  • Facility Address: 2202 HWY 82 W
    GREENWOOD, MS
    ZIP 38930
  • Facility Phone: 662 453-3967
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEBA O. MARZOUK
  • NPI Number: 1467470997
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2139499
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0716
Street 2202 HWY 82 W
City GREENWOOD
State MS
ZIP 38930
Phone 662 453-3967
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 HEBA O. MARZOUK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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