25D2139502 CLIA NUMBER - WALMART PHARMACY 10-0707

Laboratory Demographics

  • CLIA Code: 25D2139502
  • Facility Name: WALMART PHARMACY 10-0707
  • Facility Address: 1000 S STATE ST
    CLARKSDALE, MS
    ZIP 38614
  • Facility Phone: 662 624-2523
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARAH VANCE
  • NPI Number: 1396762829
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2139502
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0707
Street 1000 S STATE ST
City CLARKSDALE
State MS
ZIP 38614
Phone 662 624-2523
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 SARAH VANCE

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