26D2120091 CLIA NUMBER - WALMART PHARMACY 10-4590

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Laboratory Demographics

CLIA Number: 26D2120091

Facility Name: WALMART PHARMACY 10-4590

Facility Address:
3410 SW MARKET STREET
LEES SUMMIT, MO
ZIP 64082
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Facility Phone Number: 479 258-2243

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1255874970

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	26D2120091
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-4590
Street	3410 SW MARKET STREET
City	LEES SUMMIT
State	MO
ZIP	64082
Phone	479 258-2243
CertificateType	4
CertificateEffectiveDate	10/11/2022
CertificateExpirationDate	10/10/2024
FacilityType	Waiver

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