26D2127405 CLIA NUMBER - WALMART PHARMACY 10-0019

Laboratory Demographics

  • CLIA Code: 26D2127405
  • Facility Name: WALMART PHARMACY 10-0019
  • Facility Address: 333 S WESTWOOD BLVD
    POPLAR BLUFF, MO
    ZIP 63901
  • Facility Phone: 573 686-6539
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON CRADER
  • NPI Number: 1235156555
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2127405
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0019
Street 333 S WESTWOOD BLVD
City POPLAR BLUFF
State MO
ZIP 63901
Phone 573 686-6539
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Pharmacy
Lab Director JASON CRADER

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