25D2140093 CLIA NUMBER - WALMART PHARMACY 10-0954

Laboratory Demographics

  • CLIA Code: 25D2140093
  • Facility Name: WALMART PHARMACY 10-0954
  • Facility Address: 527 LAKE STREET
    HAZLEHURST, MS
    ZIP 39083
  • Facility Phone: 601 894-2800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIERRA GILKEY
  • NPI Number: 1063897510
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 25D2140093
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0954
Street 527 LAKE STREET
City HAZLEHURST
State MS
ZIP 39083
Phone 601 894-2800
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 KIERRA GILKEY

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