25D2140076 CLIA NUMBER - WALMART PHARMACY 10-2939

Laboratory Demographics

  • CLIA Code: 25D2140076
  • Facility Name: WALMART PHARMACY 10-2939
  • Facility Address: 200 MARKETPLACE DR
    RICHLAND, MS
    ZIP 39218
  • Facility Phone: 601 939-2958
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MIKHAYLA HALLMAN
  • NPI Number: 1548288079
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2140076
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2939
Street 200 MARKETPLACE DR
City RICHLAND
State MS
ZIP 39218
Phone 601 939-2958
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Pharmacy
Lab Director MIKHAYLA HALLMAN

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