25D2140105 CLIA NUMBER - WALMART PHARMACY 10-1271

Laboratory Demographics

  • CLIA Code: 25D2140105
  • Facility Name: WALMART PHARMACY 10-1271
  • Facility Address: 2400 HIGHWAY 19 N
    MERIDIAN, MS
    ZIP 39307
  • Facility Phone: 601 482-3170
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK SANDERS
  • NPI Number: 1083631493
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2140105
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1271
Street 2400 HIGHWAY 19 N
City MERIDIAN
State MS
ZIP 39307
Phone 601 482-3170
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 MARK SANDERS

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