25D2140088 CLIA NUMBER - WALMART PHARMACY 10-6165

Laboratory Demographics

  • CLIA Code: 25D2140088
  • Facility Name: WALMART PHARMACY 10-6165
  • Facility Address: 1733 EAST PASS ROAD
    GULFPORT, MS
    ZIP 39507
  • Facility Phone: 228 284-6990
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINH H. NGUYEN
  • NPI Number: 1730559832
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2140088
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6165
Street 1733 EAST PASS ROAD
City GULFPORT
State MS
ZIP 39507
Phone 228 284-6990
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 LINH H. NGUYEN

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