25D2139660 CLIA NUMBER - WALMART PHARMACY 10-0969

Laboratory Demographics

  • CLIA Code: 25D2139660
  • Facility Name: WALMART PHARMACY 10-0969
  • Facility Address: 9350 HIGHWAY 49
    GULFPORT, MS
    ZIP 39503
  • Facility Phone: 228 865-0505
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER J. COLEMAN
  • NPI Number: 1679590103
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2139660
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0969
Street 9350 HIGHWAY 49
City GULFPORT
State MS
ZIP 39503
Phone 228 865-0505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Pharmacy
Lab Director CHRISTOPHER J. COLEMAN

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