25D2140143 CLIA NUMBER - WALMART PHARMACY 10-0303

Laboratory Demographics

  • CLIA Code: 25D2140143
  • Facility Name: WALMART PHARMACY 10-0303
  • Facility Address: 950 MACKIE DRIVE
    HOLLY SPRINGS, MS
    ZIP 38635
  • Facility Phone: 662 252-9988
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LANDON SCALES
  • NPI Number: 1356368773
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2140143
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0303
Street 950 MACKIE DRIVE
City HOLLY SPRINGS
State MS
ZIP 38635
Phone 662 252-9988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director LANDON SCALES

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