25D2140146 CLIA NUMBER - WALMART PHARMACY 10-0258

Laboratory Demographics

  • CLIA Code: 25D2140146
  • Facility Name: WALMART PHARMACY 10-0258
  • Facility Address: 3929 N GLOSTER ST
    TUPELO, MS
    ZIP 38804
  • Facility Phone: 662 840-5546
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEX TROLLINGER
  • NPI Number: 1073530481
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2140146
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0258
Street 3929 N GLOSTER ST
City TUPELO
State MS
ZIP 38804
Phone 662 840-5546
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 ALEX TROLLINGER

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