25D2140091 CLIA NUMBER - WALMART PHARMACY 10-3059

Laboratory Demographics

  • CLIA Code: 25D2140091
  • Facility Name: WALMART PHARMACY 10-3059
  • Facility Address: 244 FEATHER LANE
    CANTON, MS
    ZIP 39046
  • Facility Phone: 601 761-6002
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NIA S. ROBINSON
  • NPI Number: 1710314687
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2140091
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3059
Street 244 FEATHER LANE
City CANTON
State MS
ZIP 39046
Phone 601 761-6002
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 NIA S. ROBINSON

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