25D2139635 CLIA NUMBER - WALMART PHARMACY 10-1025

Laboratory Demographics

  • CLIA Code: 25D2139635
  • Facility Name: WALMART PHARMACY 10-1025
  • Facility Address: 1608 VETERANS BLVD
    MCCOMB, MS
    ZIP 39648
  • Facility Phone: 601 684-1445
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LANCE C. NEWLON
  • NPI Number: 1366469777
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2139635
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1025
Street 1608 VETERANS BLVD
City MCCOMB
State MS
ZIP 39648
Phone 601 684-1445
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director LANCE C. NEWLON

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