25D2166589 CLIA NUMBER - WALMART PHARMACY 10-3913

Laboratory Demographics

  • CLIA Code: 25D2166589
  • Facility Name: WALMART PHARMACY 10-3913
  • Facility Address: 1200 MAGNOLIA WAY
    BLUE SPRINGS, MS
    ZIP 38828
  • Facility Phone: 662 317-3000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA P. SHIPMAN
  • NPI Number: 1669037958
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2166589
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3913
Street 1200 MAGNOLIA WAY
City BLUE SPRINGS
State MS
ZIP 38828
Phone 662 317-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director AMANDA P. SHIPMAN

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