26D2029622 CLIA NUMBER - EXPRESS CARE AT WALMART

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Laboratory Demographics

CLIA Number: 26D2029622

Facility Name: EXPRESS CARE AT WALMART

Facility Address:
3650 STARDUST DRIVE
HANNIBAL, MO
ZIP 63401
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Facility Phone Number: 573 248-5151

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1083154991

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D2029622
LAB Type	Community Clinic
Facility Name	EXPRESS CARE AT WALMART
Street	3650 STARDUST DRIVE
City	HANNIBAL
State	MO
ZIP	63401
Phone	573 248-5151
CertificateType	4
CertificateEffectiveDate	9/12/2023
CertificateExpirationDate	9/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024