25D2140682 CLIA NUMBER - WALMART PHARMACY 10-0411

Laboratory Demographics

  • CLIA Code: 25D2140682
  • Facility Name: WALMART PHARMACY 10-0411
  • Facility Address: 660 E MADISON ST
    HOUSTON, MS
    ZIP 38851
  • Facility Phone: 662 456-9244
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMICA N. STEPHENS
  • NPI Number: 1437176849
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2140682
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0411
Street 660 E MADISON ST
City HOUSTON
State MS
ZIP 38851
Phone 662 456-9244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Pharmacy
Lab Director TAMICA N. STEPHENS

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