25D2139678 CLIA NUMBER - WALMART PHARMACY 10-1530

Laboratory Demographics

  • CLIA Code: 25D2139678
  • Facility Name: WALMART PHARMACY 10-1530
  • Facility Address: 710 NORTH DAVIS AVENUE
    CLEVELAND, MS
    ZIP 38732
  • Facility Phone: 662 846-6008
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAURA S. GRIFFIN
  • NPI Number: 1528085933
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2139678
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1530
Street 710 NORTH DAVIS AVENUE
City CLEVELAND
State MS
ZIP 38732
Phone 662 846-6008
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 LAURA S. GRIFFIN

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